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Cerritos Senior Center
at Pat Nixon Park

12340 South Street
Cerritos, CA 90703

(562) 916-8550

Senior Health and Wellness Fair Vendor Registration Form

This registration form is due no later than Friday, September 16, 2022. Vendors may also fill out a paper copy of the vendor form in person at the Cerritos Senior Center.

Space is limited, so please complete and submit this form as soon as possible. Applicants will be evaluated on a first-come, first-served basis and spaces will be assigned as applications are approved. In order to achieve a balance in the types of vendors represented at the Fair, the Cerritos Senior Center reserves the right to limit duplication of service providers. Event participation approval will be sent by email no later than Wednesday, September 28, 2022. If you do not receive a notification about event participation by this date, please contact Melissa Pizano at (562) 916-8550.

If approved, appropriate fees are due to the Cerritos Senior Center by Friday, September 30, 2022. Fees are non-refundable and checks should be made payable to the City of Cerritos. 

For additional information, visit the Senior Health and Wellness Fair Registration page, or call the Cerritos Senior Center at (562) 916-8550.

Vendor Contact Information

Contact Person Name

Vendor Mailing Address

Vendor Details

What type of agency are you?

Do you require an electrical outlet?

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