Prospective Vendor Registration Form

Business Name *

First Name *

Last Name *

Prefix

Suffix

Pronouns

He/Him/His

She/Her/Hers

They/Them/Theirs

Department

Job Title *

Email *

Phone 1 *

Phone 2

Business Address Line 1 *

Address Line 2

City *

State/Province *

County *

Zip/Postal Code *

Country *

Preferred Contact Method

Email

Phone Call

Text

Business URL *

Please enter the most active URL for your business whether it be your website, Instagram, Facebook, etc. This is what we'll link or tag when we advertise events you are participating in.

Business Location Type

Brick & Mortar

At Home or Mobile Business/Vendor

Business Category

Business Sub-Category

Contact Type *

Resident

Volunteer

Business Owner

Event Vendor

Artist

Musician

Press Contact

Check all that apply.

What is your relationship to the West Side? *

Check all that apply.

Languages Spoken

English

Spanish/Español

Korean/한국어

Chinese/Mandarin/普通话/普通話

Other

Check all that apply. This field is optional. If you choose not to respond, please select "Decline to State".

Race & Ethnicity

Asian American/Pacific islander/Asian

Black/African American/African

Latino/Latina/Latinx/Latine

Native American/American Indian/Indigenous American

White/Caucasian/European

Decline to state

Other

Check all that apply. This field is optional. If you choose not to respond, please select "Decline to State".

Veteran Status *

Veteran

Not a Veteran

Decline to State

This field is optional. If you choose not to respond, please select "Decline to State".

Disability Status *

Person with a disability

Person without a disability

Decline to state

This field is optional. If you choose not to respond, please select "Decline to State".

Data Privacy & Consent

Yes, I would like to receive communications from West Side Grows Together by email.

Yes, I would like to receive communications from West Side Grows Together by phone.

Yes, I would like to receive communications from West Side Grows Together by mail.

Yes, I would like to receive communications from West Side Grows Together by SMS.