FARM PRODUCE VENDOR APPLICATION

Fee: $25.00

DATE: __________________________________________________________

NAME OF APPLICANT: ___________________________________________

ADDRESS: ______________________________________________________

EMPLOYER: _________________________ SELF EMPLOYED: _________

PHONE NUMBER: ____________________ BIRTHDATE: ______________

ADDRESS DURING PREVIOUS YEAR: _____________________________

________________________________________________________________

GOODS BEING SOLD: ____________________________________________

________________________________________________________________

________________________________________________________________

LOCATION OF MARKET: _________________________________________

Please Do Not Write Below This Line

--------------------------------------------------------------------------------------------------

__________________________________ ________ Approved

Chief of Police ________ Denied

____________________________________ ________ Approved

City Treasurer ________ Denied

____________________________________ ________ Approved

City Planner ________ Denied