Online Form - Farmer's Market Vendor (FMV) Application

Asterisks (*) indicate required fields

Date *

Business Name *

Owner Name *

Title

Mailing Address *

City *

State *

Zip *

Cell Phone Number *

Email *

Location / Event 1 *

Location / Event 2

Location / Event 3

Location / Event 4

Location / Event 5

Location / Event 6

NOTE: ALL FOOD MUST BE PREPARED AT THE FARMER'S MARKET. COOKING DEMONSTRATIONS MUST BE SUPERVISED BY A CERTIFIED FOOD HANDLER

A Copy of the menu (Acceptable file formats: pdf, gif, jpeg, jpg, png, bmp) *

Food Handler Certificate (Acceptable file formats: pdf, gif, jpeg, jpg, png, bmp) *

Certification *

I, the owner of this business, certify that the above information is true and accurate as of the date of this application

Applicant *