National Night Out Against Crime 2019

Legislator Kevan Abrahams
National Night Out Against Crime 2019
Aug 6th 2019 - Time 6 - 8:30 pm - (set up at 4:30 pm)
Location: Sherman Van Ness Fire Station
154 Uniondale Ave. Uniondale 11553
(Btwn Hemp Tpke & Front St.)

For vendor participation please fill out this registration form no later than
Aug 1st 2019

(All names submitted by this date may be included in the final event press release)
Includes: FREE Space - Table & 2 Chairs (bring your own table covering & canopy)

Please Fill Out the Information Below

Company/Agency Name *

First Name *

Last Name *

Address *

City *

State *

Zip *

Phone# *

(Ex. 1234567890 or 123-456-7890)

Cell# *

(Ex. 1234567890 or 123-456-7890)

Fax

(Ex. 1234567890 or 123-456-7890)

Email *

Type of Service you will provide to the Community

Giveaway(s) you will provide

(Ex. tote bags,brochures,bulbs,pens, gift cards etc.)

If available, do you require electrical power?

Willing to donate item for raffle

Special request

SPONSORSHIP/ADVERTISING OPPORTUNITIES ARE AVAILABLE
PLEASE Call 516 - 571 - 2455 for additional info

*Nassau County Legislature shall not be liable for any loss, stolen or damaged
personal property, however incurred. All personal property is carried at your own risk.

* Mandatory Fields