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First Name

Last Name

Email *

Phone *

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company.

Organization

Your Organization's Website

Your Organization's Instagram Name

Your Organization's Facebook Name

Can you provide 100 items to be donated to the community? (No Food and Pens)

Yes

No

Please choose the 100 items that you are willing to donate:

If other, please provide the details of the items that you wanted to donate. ( No Food and Pens)

Are we able to send you a flyer that you can share about the event to your email list, during meetings and on your social media?

Yes

No

1 table & 2 chairs will be provided on first come first serve basis unless otherwise specified. (We encourage you to bring your own if you can)

Willing to share table

Will bring own table and chairs

Please tell us about your Organization. What do you do and who do you service?

Please upload your Company/Organization logo

Please upload some photos of the activities of your company/organization

Please provide the names of events you participated. Please also provide the contact names and email addresses of the event organizers as a reference.

Registrations Are Closed Now

Be one of our Community Partners

© 2025by JuneteenthNYC

© 2025by JuneteenthNYC