1. CONTACT INFORMATION
Name: ________________________________________________________________________________
Business/Non-Profit Name: _______________________________________________________________
Industry: ______________________________________________________________________________
Address: ______________________________________________________________________________
Address (Line 2): _______________________________________________________________________
City/State/Zip: _________________________________________________________________________
Phone: _______________________________________________________________________________
Email: ________________________________________________________________________________
Website: ______________________________________________________________________________
Social Media:
□ Blog: _____________________________________________________________
□ YouTube: __________________________________________________________
□ Facebook:
o
o
Personal: __________________________________________________
Business Page: ______________________________________________
□ Twitter: ___________________________________________________________
□ LinkedIn: __________________________________________________________
□ Other: ____________________________________________________________
Please email your logo in jpg format to keli@traumatotriumphinc.org

2. Vendor Requirements
By checking the below I understand/agree to the following:
□
□
Vendor is willing to join Trauma to Triumph as member of:
o
Website
o
Facebook Page (Like)
o
Facebook Group (Join)
Vendor is responsible for setting up and taking down materials and displays and
cleanup of the area
□
□
Vendor is responsible for any applicable state and local sale’s tax
Vendor is responsible for any applicable state and local licensing and insurance
requirements
□
Vendor agrees to indemnify, defend, and hold harmless Trauma to Triumph, its
Board, Members, or Volunteers, Sponsors, Employees, and Agents, from all claims, liabilities,
losses, damages, expense, accidents, and occurrences (including attorney fees) arising out of,
or in connection with the performance of this agreement, activities associated with Trauma to
Triumph. *
Trauma to Triumph Board Member:
(President, Vice-President, Treasurer ONLY)
Name: __________________________
______________________
Vendor’s Name:
Title: ____________________________
___________________________
Signature:
Signature: __________________________

3. * Please note that Trauma to Triumph is a 501(c) non-profit organization and all donations are tax
deductible. Please provide accurate contact information to receive your tax
contributions/deductions at the end of the year. Thank you for your support!