Skip to content
Home
Agenda
Day 1
Day 2
About
ICC
Interprofessional Clinical Conference Agenda
Speakers
Vendor Registration
Sponsorships
Hotel
Menu
Home
Agenda
Day 1
Day 2
About
ICC
Interprofessional Clinical Conference Agenda
Speakers
Vendor Registration
Sponsorships
Hotel
Register
Grantee
Grantee Project Submissions
Hilton Garden Inn Olive Branch
7890 Craft- Goodman Frontage Road Olive Branch, MS 38654
Exhibitors' Registration Form
Grantee Project Submissions
Please complete the project submission by September 6th.
Please enable JavaScript in your browser to complete this form.
Coordinator Name
*
First
Last
Email
*
Organization Name
County
Grantee Type
Church
Mayor Health Council
Barbershop/Beauty Shops
Tunica
Healthcare System
Public Housing
Pharmacy
Please provide a summary report of your organization's activities (250 word count max).
Upload an Action Shot Photo 1 of 2
Click or drag a file to this area to upload.
Upload an Action Shot Photo 2 of 2
Click or drag a file to this area to upload.
Submit
