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Provider Interest Form For Participation at Dignity Day
Provider Interest Form For Participation at Dignity Day
April 11, 2026- 9:00-2:00PM
Event Location: 2166 Sacramento Street Vallejo CA 94590
Applicant Name
*
Applicant Name
First Name
First Name
Last Name
Last Name
Applicant Title
*
Date
*
Name of Company
*
Type of Provider
*
Non-profit
Private Business
Public Business
Type of Services Provided
*
Service Area
*
Local
Regional
National
Do you provide services to people who are unhoused
*
Yes
No
Are You Able To Participate On Saturday’s (All of our events take place on the 2nd Saturday of each month. Dignity Day takes place on the 2nd Saturday of April and September annually).
*
Yes
No
How Many Of Your Staff Will Attend?
*
Do you have a pop-up tent?
*
Yes
No
**Maximum allowable size is 10’x10’
Are you able to provide your own table and chairs?
*
Yes
No
**We are unable to provide tables and chairs
Are there any requirements you have?
**We are unable to provide for any electrical requirements or internet connections
Do you supply company related gifts for our event guests?
*
Yes
No
If so, please explain what type.
Will your company consider a monetary donation to help support Dignity Day?
*
Yes
No
If you have questions, please email us at:
support@solanodignityandcare.org
Submit
If you are human, leave this field blank.
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