Health Fair and Senior Expo Friday, July 21 10 a.m. to 2 p.m. Hickory VFW 5550 E State St. Hermitage, PA 16148 Vendors will be there to provide information about programs and services for senior citizens. All vendors interested in attending please fill out the form below to register for the event. Organization Name * Representative(s) Attending * Phone * Address * City * State * PA AA AE AK AL AP AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Zip Code(5-Digit) * Email Address * Leaving this box checked verifies that you would like to receive legislative email updates. Service/Tests/Info you will be offering (ex: blood pressure, hearing tests, flu shots, etc.) * Please describe any raffles/giveaways you will be having at your table * Please write 1—2 sentences about your company for the program: * Do you require electrical outlets? * YesNo Will you be donating a door prize? * YesNo Submit