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Senior Expo Registration

Please fill out the form below to contact us.

1. Select Your Level of Partnership:
 


2. Link your website through ours by including your web address in Step #6 below

3. Order Additional Equipment:* (Please Specify Quantity)
Request and payment of additional equipment is required in advance.
  Electricity (*See Below)
6' skirted/covered table ($45.00 ea.)
8' skirted/covered table ($50.00 ea.)

(* If you request Electricity, prior to October 30th the cost is $55.00. After October 30th the cost will be $80.00. Electricity can’t be ordered the day of the event)

4. Use ONLY 30 letters in your Company’s name when completing #6.portion
Information used for booth sign/event program/referral sheet. (Spaces are a letter).

5. Payment

Credit card payments by Visa, MasterCard, Or American Express can be made online by clicking the link below.
Pay Now

For Discover payment call Jo at 480.964.9014 ext 107 or Becky at 480.964.9014 ext 106.
To pay by check/money order, mail to:
  East Valley Senior Services, Inc.
Attn: Development Office
45 West University Drive Suite A   Mesa, AZ 85201

6. Company Info:
    (30 words or less)
  Contact Person:
  Phone:
  Fax:
  Email:
  Company Website:
 
  Address:
  City:
  State:
  Zip:


             
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