Rep. Wilhour’s 2024 Senior Fair – Vendor Registration

Please complete and submit the form below to register as a vendor for Rep. Blaine Wilhour’s upcoming Senior fair on Tuesday, April 23 from 9 a.m. to 11 a.m. at the Salem Community Activities Center, 416 East Oglesby Street, Salem, IL 62881

Space is limited and will be filled on a first come first served basis.

Call Rusty Corneils at 630-779-4565 with any questions.

Vendor Name(Required)

First Last

Organization

Email(Required)

Enter Email Confirm Email

Phone(Required)

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Do you need electricity for your booth?(Required)

Will you be providing health screenings?(Required)

What type of screening will you be providing?(Required)

Will you be bringing a door prize?(Required)

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