Senator Langerholc’s Senior Expo Thursday, September 29, 2022 10 a.m. – 12 p.m. East Hills Recreation Center 101 Community College Way #118 Johnstown, PA 15904 Registration deadline is August 12, 2021 Sen Langerholc Senior Expo Registration This information is for the Program BookletOrganization Name(Required) Organization Mailing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Please use the space below to indicate the information you would like to have included in this year’s exhibitor directory. Feel free to include your organization’s mission statement, available services, contact info, etc.(Required)Exhibitor's Name(Required) Email (Used for Confirmation)(Required) Enter Email Confirm Email Exhibitor SpaceThe information below will help us determine your needs for your space.If you require more than the two CHAIRS that are provided, how many TOTAL chairs do you need?Please tell us how many chairs you need for your exhibit, 2 are provided, if you need 4, please tell us 4. Check One - My exhibit, when placed upon a table, is higher than 3 feet.(Required) Yes No Is your organization willing to share a table? Please provide the name of the organization you are willing to share a table with. Check One - This organization is a non-profit (501c3) or governmental agency(Required) Yes No I/We will be providing a healthcare screening. Yes No If Yes, describe health screening. EmailThis field is for validation purposes and should be left unchanged.