Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Organization/Business/Affiliation Type

Please check all that apply.

TRANS/GENDER EXPANSIVE LED NON-PROFIT

TRANS/GENDER EXPANSIVE ARTIST

TRANS/GENDER EXPANSIVE OWNED SMALL BUSINESS

NON-PROFIT/ORGANIZATION/BUSINESS WHOSE MAIN DEMOGRAPHIC IS TRANS/GENDER EXPANSIVE INDIVIDUALS

SMALL NON-PROFIT ORGANIZATION (operating budget under $1.5 Million)

LARGE NON-PROFIT OR NGO (operating budget over $1.5 Million)

SMALL BUSINESS

LARGE BUSINESS

HEALTHCARE PROVIDER

HEALTHCARE PROVIDER SPECIALIZING IN TRANS/GENDER EXPANSIVE CARE

RELIGIOUS/FAITH BASED INSTIUTION

FOOD VENDOR

BEVERAGE VENDOR

Do you identify as any identity under the trans umbrella or gender expansive community?

(We are giving special consideration to vendors and partners who are trans and gender expansive to specifically highlight their businesses/organizations.)

Yes

No

Prefer Not to Say

Please acknowledge below that you understand that submission of a tabling partner application does not confirm or guarantee acceptance as a tabling partner. I also understand that if accepted, my registration is not complete until my payment is made in full, if applicable. *

I understand and agree