Milwaukee Service Provider/Resource Table Registration

Agency/Company Name 

Contact Person - First Name

Contact Person - Last Name

Contact Person - Email

Which of the following are you registering for?Resource fair tableEmployment fair tableHaircutting serviceManicuristsHealthcare service that will need its own roomLegal service that will need its own roomOther service that will need its own room

What service and/or resource will your agency provide?

Please provide a brief description of your resource/service as you would like it to appear in a packet of on-site information for attendees.

What are your set-up needs? (i.e., access to electrical outlets, need to be near restroom, etc.) 

Have you been a Project Homeless Connect service provider or resource table before?
YesNoUnsure

Is there any additional information you would like us to know? (i.e. additional contact names and emails, your agency can only attend a portion of the day, your agency would like to provide an event sponsorship, etc)