Seniors Expo Service Provider Registration Form

Thank you for expressing your interest in being a service provider at the 2023 Seniors Expo!

Please complete this application form and return it by May 19, 2023. 

Once submitted, a member of the Expo planning team will be in contact to discuss your application and confirm registration. 

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Email *
Main Contact Name
 *
Agency/Business Name:
 *
Telephone
 *
Website
Address
Please Indicate the type of service(s) you provide. Please check all that apply.
 *
Required
Please describe the type of service(s) your agency/business provides *

Service Provider Information: 

Event date: Thursday, June 1st from 10:00am to 2:00pm

Set-up: Thursday, June 1, 9:00 a.m. – 10:00 a.m. 

Tear-down: Thursday, June 1, 2:00 p.m. – 3:00 p.m.  No early tear-down. 


What we are providing: 

- One table and two chairs (6ft-8ft table)

- 10ft x10ft space


Service Providers must provide: 

- Tablecloth or cover

- A professional-appearing display 

- Set-up and tear down of display 

- Staff or volunteer(s) at the booth for the entire duration of the event
Prizing
To promote engagement during the event, we would like to provide participants quality prizes. If you are able to donate a prize for the event, it would be greatly appreciated.

Will you be contributing a prize for the Expo? *
Required
If yes, what will you be contributing

Volunteer opportunities 

We would like to showcase volunteer opportunities for older adults in our community at this event. We will have a volunteer booth, where participants will learn about what they could get involved in. If your organization has any volunteer opportunities. 

Are you interested in advertising your volunteer opportunities at our Volunteer booth?

 *
Required

Workshop/Demonstration

If you would like to host a workshop at the Expo, please let us know. We will have access to a meeting room with a max occupancy of 25 people for service providers to hold workshops or theater style presentations (e.g., falls prevention).

Would you like to hold a workshop?

*
Required
If yes, please provide a brief description

Future Events

Are you interested in being contacted for future events by Loyalist Township? *
Required

For additional information or any questions, please contact: 

Telephone:  613-507-0213 ext 201 Email:seniors.expoloyalist@gmail.com
A copy of your responses will be emailed to the address you provided.
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