Vendor Registration Form
Vendor registration form for Atlanta Victim Assistance, Inc.'s Lacing Up Against Domestic Violence 5K and Resource Fair.
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Company Name *
Company Type: *
Website: *
Address: *
City, State, Zip: *
Contact Person's Name, Phone, and Email: *
Number of staff or representatives attending: *
Are you participating in the 5K race? If so, how many will participate? (At least one person must remain at your table.) *
Are you providing an activity at your table? (E.g. yoga). If so, please include the title and a brief description.

Please note, you must provide your own materials. An AVA staff member will schedule the time of your activity.
*
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