NESF World Homeless Day Event Friday, October 8, 2021 10am – 2pm Lincoln Park – Newark, NJ AGENCY NAME Organization CONTACT PERSON First & Last Name PHONEEMAIL Type of Agency: Nonprofit Community Based Organization Medical Third Choice Government Legal Private Corporation Other: Type of Service/Program/Information to be provided: (Check all that apply) Housing Services Clothing Employment Food Medical Screening Mental Health Substance Abuse Legal Other (please give details): All vendors are to arrive at the NESF Registration Table no later than 9:00 am to check in. All vendors MUST receive a wristband at check-in BEFORE setting up at their assigned location. Vendors must provide their own tables and chairs for the event and are also responsible for maintaining a clean area. Number of tables: Number of chairs: Number of staff attending: Tent: Yes No Banner/Sign: Yes No Mobile Unit: Yes No Comments:By signing this form, I agree to follow all protocols and procedures put in place by the event organizers. Signature Write Name Here Date MM slash DD slash YYYY
