UMKC CommUniversity Online Class Registration

Wholistic Health Fair Booth application


  • Look at a map of Student Union, Multipurpose Room here and choose what booth you would like before filling out this form.

  • PLEASE NOTE: Your booth reservation is not complete until we receive payment. You may pay over the phone with a credit card or by mail with a check.


* indicates required field
How many booths would you like to reserve*  
Booth number you choose 1st choice
2nd choice

Contact and Show Guide Information

Please indicate what information you would like included in the show guide
Company Name* List in Show Guide?
Wholistic Service List in Show Guide?
Exhibitor Name #1 List in Show Guide?
#2 List in Show Guide?
#3 List in Show Guide?
#4 List in Show Guide?
Contact Person* List in Show Guide?
Address* List in Show Guide?
City*    
State*    
ZIP*      
Phone Number* (xxx-xxx-xxxx)   List in Show Guide?
Fax Number (xxx-xxx-xxxx)   List in Show Guide?
Email*   List in Show Guide?
Website List in Show Guide?

I would like to teach a 45 minute workshop at the Health Fair (if yes, please also fill out Wholistic Health Fair Speaker Form)
Do you need electricity?*
Do you need extra space?*
Do you have any items for sale?
If yes, list your items
 

Silent Auction Information

I would like to donate a product or service to the Silent Auction
Please list product or service value in $ 
I've included a certificate with the application
I will bring the product with me
Please make a certificate (Please, include the information to be included on certificate)
 

Total Amount 


Please select your payment method



I agree to the terms and conditions of this contract * No refunds, no cancellations
Captcha Challenge - Please add the numbers: 37  + 86  =   



If you choose to pay by credit card, you will be asked to enter your credit card information on the next page. Your registration is not completed until your payment is received.