Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Organization or business type. *

*Check ALL that apply*

LGBTQIA+ LED NON-PROFIT

LGBTQIA+ ARTIST

LGBTQIA+ OWNED SMALL BUSINESS

SMALL NON-PROFIT ORGANIZATION (operating budget UNDER $1.5 Million)

LARGE NON-PROFIT OR NGO (operating budget OVER $1.5 Million)

SMALL BUSINESS

LARGE BUSINESS

HEALTHCARE PROVIDER

HEALTH CARE PROVIDER SPECIALIZING IN LGBTQIA+ CARE

RELIGIOUS/ FAITH INSTITUTION

FOOD VENDOR

BEVERAGE VENDOR

Table / Vendor Location and Features *

Please check all that apply, and we will try our best to accommodate your request.

Indoor Vendor Location

Indoor Vendor Location with Electricity

Outdoor Vendor Location

Shared Tent

Bring My Own 10x10 Tent

I understand *

I understand that by submitting a tabling/vendor application, my request is not guaranteed to be accepted. I understand that if accepted, my registration is not complete until my payment is made in full, if applicable.

I understand and agree.