2. Health Fair Vendor Application

   Date: May 20, 2023 

   Location: Burlington High School, 123 Cambridge Street

   Interested in being a vendor at the 2023 Health Fair?

   Fill out the Online Form below to register to be considered. If you are having trouble with the Online Form, please fill out the paper version here and either mail it or drop it off at our office located at 61 Center Street Burlington, MA, email it to boh@burlington.org, or Fax it to 781-273-7687. Call our office with any questions or concerns you may have regarding the application process at 781-270-1955.

4. Name of Organization*
5. Contact Person and Title:*
7. Phone Number*
8. Email Address*
10. Mailing Address
12. City
13. State
14. Zip Code
16. In what way(s) would your organization like to participate in the Health Fair?
18. Informational Table*

    1. Yes
    2. No

    (tables will be provided free of charge by the Board of Health)

19. Do you need a full 6 foot table?*

    1. Yes
    2. No

    For your informational table, are you able to share a 6ft. table with another vendor in the case that there are more vendors than tables available for the event?

21. Exercise Demonstration*

    1. Yes
    2. No

    (demonstrations are held in the designated areas at assigned time slots- this is separate from doing a something next to your table) i.e.: If you would like to bring your class to show the public how to do an exercise routine. 

22. If yes answered for exercise demonstration, approximately how much time will be needed?
24. Please describe the type of demonstration, and/or the information that will be provided at your table.*
26. Do you require an outlet to run your table?*

    1. Yes, I can not run my table without it
    2. Yes, only if there are extra outlets available
    3. No, not needed for my table
27. If yes answered for requiring an outlet, please elaborate what are you using the outlet for?

    If the item needing power is large, please let us know approximately how much power it may needed.

29. Do you need extra space next to your table?*

    1. Yes
    2. No

    (permitting space is available)

30. If yes, please elaborate approximately how much space is needed and what the extra space would be used for?

    (i.e. Our company has a machine that does screenings that needs about 4ft next to table)

32. Will you have a raffle item?*

    1. Yes
    2. No
33. If yes answered for raffle item, what will the raffle item be?
35. Do you want to offer a free food item sample at your table?*

    1. Yes
    2. No
36. If yes answered for offering food item(s), please list all the food item(s) that you wish to bring.

    These food items must be health related; no candy. You may be asked to complete a Board of Health temporary food permit application. If needed, a staff member from the Board of Health will reach out to you to complete this application. 

38. Burlington Community Health Fair Terms and Conditions*

    • Exhibitors are prohibited from requesting Medicare or social security numbers or any other personal information (e.g. phone numbers, email addresses) from Health Fair patrons.
    • All activities and demonstrations must be approved prior to the event.
    • Food items and balloons are not allowed.  Food items may be distributed only if part of a cooking demonstration and/or approved prior to the event. 
    • Items may not be sold at the event and all raffles must be free of charge.
    • Exhibitors are responsible for their tables including clean up, which should not begin until the completion of the event.  
    • Exhibitors must arrive one hour prior to the start of the event.
    • Tables must be staffed for the entire 3 hours of the event.
    • Access to electricity will be provided only to those exhibitors that requested it prior to the event.
    • Each exhibitor is responsible for unloading and loading of their equipment and materials.  Supplies may be dropped off/picked up at the gymnasium door of the school, however, exhibitor parking is located in the student parking lot.   
    • Exhibitors must bring their own table covering for a 6 foot table.

    1. By checking this box, I agree to the above rules
40. Signature of Applicant*

    This is an electronic signature to submit your application, there is no need to print or download this form for a physical signature.

41. Date*
    Date

43. Applications due to Board of Health Office by March 14, 2023

    (Any Applications received after the deadline will be considered on space availability.)

Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

* indicates a required field