Community Partners Application 2023

You are invited to participate in the 15th annual Juneteenth NY Celebration on Saturday, June 15, 2024 at 11 AM to 6 PM.

Please complete the registration form before Wednesday, May 15, 2024. Setup logistics will be sent once confirmation is received. If the organization is a non profit, Your EIN# is required.

Full Name *

Phone *

Email *

Organization *

If your organization is a non profit EIN# is required *

What Area Is Your Organization Providing Services/Resources For At This Event? Check All That Apply. *

Health Organization

HBCU

Library

Governmental Agency

Others

Website *

What is your instagram/ facebook name? *

Number of Emails stored in your Database *

Number of IG Followers *

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 your 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/orgnization

15 Max File Limit

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

Community Partners Application 2024