Hispanic Heritage Month Family Day

Beltway Plaza Mall

Hispanic Heritage Month Family Day

Merchant Registration Form

Please fill in this form and submit to the Beltway Plaza Marketing Office, 6000 Greenbelt Road, Greenbelt, MD 20770 by September 15, by 5:00 pm. Contact Janubi Devendra at 301-345-2040, via email at jdevendra@quantumco.net or Jon Enten 301-980-0666 email jonenten@gmail.com to register or for more information or questions.

More details will be provided after your participation form is turned in.

Date:
Store Name:
Store Manager/Owner Name:
Email address:
Store Address:
Phone Number:
What will you be displaying at the event (i.e. sell products, demonstration, give aways, literature, etc.)? Please describe:


Do you need an electrical hookup?
Yes No