LAKE STEVENS FARMERS MARKET 2014 APPLICATION

PO Box 439

Lake Stevens, WA 98258

425-334-0433

www.lakestevenschamber.com

Vendor’s Name______

Required: UBI # ______

Required: City of Lake Stevens Business License #

______

Business Name ______

Farm Location ______

Home Phone ______

Business Phone ______

Cell Phone ______

Email ______

Website ______

Mailing Address ______

______

Please check those that apply:

Farmer

Certified Organic

Cut Flowers

Processor

Honey

Food Concessions

Nursery

Baked Goods

Seafood

Meat

Dairy

Crafts

Beer/Wine H

Other

Describe the crops or products you intend to sell

*Any products not listed here will not be permitted

To be sold without prior permission

______

______

What other markets do you sell at?

______

List family members or employees who may sell for you?

______

______

What type of vehicle will you be bringing? ______

I would like to reserve a vendor space for the following dates:

8/1 9/5

8/8 9/12

8/22 9/19

8/29 9/26

Fees Enclosed:

$15 Registration Fee

$25 for each date (10’x10’ space)

$40 for each date (over 10’x 10’ space

Or Food Truck)

Copy of Special Event/Host Liquor Liability Insurance Certificate