Stall Holder Application Form

Name of Applicant

Name of Proposed Stall

ABN

Please provide a photo of your existing stall if you have one Please provide a photo of your existing stall if you have oneI will email a photo to info@organicfoodsandfarmersmarket.comI don't have an existing stall

Email Address

Website / Facebook / Instagram

Phone Number

How often would you like to attend the market? How often would you like to attend the market?WeeklyFortnightlyMonthlyCasual

Start Date 2019 Start Date 201927 April4 May11 May19 May25 May1 June8 June15 June22 June29 June

Please select your relevant category Please select your relevant categoryFarmer / ProducerResellerCoffee / DrinksHot / Cold FoodSpecialty Food MakerCraft / Art / Textiles Maker (not food)Wellness / TherapyFundraiser / CharityOther

Check this if you want us to sell on consignment for you Check this if you want us to sell on consignment for you I want you to sell on consignment for me

If you are a food seller do you have a relevant operating license? If you are a food seller do you have a relevant operating license?I have a current Food LicenseI don't need a food license

Please email a copy of your food license Please email a copy of your food licenseI will email a copy of my food license to info@organicfoodsandfarmersmarket.comI don't have certification

Please describe your mission / offer / vision

Please describe your product(s) and give a brief overview

What certification can you provide us? What certification can you provide us?Organic CertificationRecent MRL or other official reportsFree Range CertificationProduct List (for resellers)Other

Please email a copy of your relevant docs Please email a copy of your relevant docsI will email relevant docs to info@organicfoodsandfarmersmarket.comI don't have certification

What is the origin of your product(s)?

What is your Organic Status? What is your Organic Status?I am a certified organic operatorI am in the process of being certifiedWe are ethical operators and use authentic organic methods, without artificial inputsWe are not certified, but we use only certified organic inputs and ingredients

Do you have $10m Public Liability Insurance? Do you have $10m Public Liability Insurance?YesNoI will organise itN/A (Goods on consignment)

Please submit a copy of your Insurance Certificate Please submit a copy of your Insurance CertificateI will email insurance certificate to info@organicfoodsandfarmersmarket.comI don't have a certificateN/A (Goods on consignment)

What size space do you need? What size space do you need?Table Stall (1.8mx1.8m)3 x 36 x 39 x 3Other

If Other - please describe the size you require

Do you need a vehicle / trailer on site? Do you need a vehicle / trailer on site?Refrigerated Truck 6-8 tonneRefrigerated Truck / Van 2-5 tonneRefrigerated Truck / Van / Vehicle under 2 tonne (without trailer)Refrigerated Truck / Van / Vehicle under 2 tonne (with trailer)Vehicle with TrailerVehicle without TrailerTrailer OnlyNo vehicle required.

Do you require a powered site? What Amps? Do you require a powered site? What Amps?10amps15ampsNone - No Power needed

Acknowledgement Acknowledgement I acknowledge that I have read the Stallholder Information and Market Regulations and will abide by the conditions.

Additional Comments or Feedback?