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Lilydale Farmers Produce Market
A project of the Rotary Clubs of Lilydale & Montrose
EXPRESSION OF INTEREST FORM
Business NameABN (if applicable)
Contact person
Position:
Will you be attending the market?
If not, who and why?
Phone
Mobile
Email: (please print clearly &
update regularly!)
Address
Suburb/Town
Postcode
Website:
The Lilydale Farmers Produce Market (Organised by the Rotary Clubs of Lilydale & Montrose)is particularly interested in stall holders whodemonstrate
the following in their business/produce/product.
For any statement that applies to you, please briefly describe how:
1. Excellent taste; balance, origin and complexityYES / NO
2. Small-scale or handmade method/productionYES / NO
3. Specific cultural, community or varietal heritageYES / NO
4. Natural ingredients i.e. no chemical enhancers, preservatives or artificial colouring
YES / NO
5. A positive affect/effort towards environmental sustainabilityYES / NO
6. No genetically modified ingredientsYES / NO
7. A healthy respect for fair prices, animal welfare and people involved in the
production of goods and servicesYES /NO
1.BUSINESS TYPE
Please answer as best you can all sections that apply to your business.
Feel free to attach extra pages for our information. Your answers and these details
may assist the Lilydale Farmers Produce Market in publicising your enterprise.
A/ FARMER/GROWER
Please give details of the range of products, varieties and seasons of produce:Do you grow/produce your own goods/produce entirely? / YES / NO
Are you certified organic? (please show certification) / YES / NO
If not, please outline your chemical regime?
Are any of your goods value added/processed?
Do you do this yourself? If not, who does?
Please complete section 2 and/or 3
B/ VALUE ADDER/PROCESSOR/MANUFACTURER
Please list in detail the range of products you propose to bringWhat proportion of your ingredients do you grow? (0%-100%) / %
Where do you source any other ingredients?
If details are available please provide an ingredients list and details of suppliers of produce that you do not grow.
If you do not grow your ingredients, what other reasons would justify your products being sold at a farmers’market? / Other stallholders: %
Growers in your area: %
Wholesale market: %
Interstate or imported: %
Is your packaging/tasting equipment as minimal and environmentallyresponsible within health regulations ? / YES / NO
C/ FOOD VENDOR SELLING COOKED FOODS, DRINKS, etc
What do you propose to sell?Do you grow any and if so what ingredients?
If no, where do you get the ingredients and who supplies the produce?
Will you use produce from other stallholders and if so what?
What packaging and serving receptacles do you intend to use. Are they environment friendly?
YOUR APPLICATION
Do you intend to be involved on a -monthly,- seasonal, -casual,- or -some other basis?
Monthly/Seasonal/Casual/Other. ______
POWER
Do you require access to power? / YES / NOPlease detail equipment & amps required. All equipment must be tagged & tested.
Do you have a generator? / YES / NO
Is it silent? / YES / NO
*Power will only be made available if required to meet health regulations or is mandatory for operational requirements.
VEHICLE
Do you require a vehicle* onsite? / YES / NOPlease provide details of vehicle, including dimensions and why you need it.
*Vehicles may only be kept onsite if they are required to meet health regulation or are really necessary.
For reasons of safety, vehicles may not move within the market area 15 minutes prior to
and until 15 minutes after the advertised trading hours of operation.
FOOD SAFETY AND INSURANCE
Are your Food Premises, Food Vehicle and/or Temporary Structure registered under the Food Act? / YES / NODo you have product and public liability insurance? / YES / NO
Please provide with this application a copy of current insurance with clear reference to
public liability and specifically for markets.
OTHER MARKETS
Do you participate in other farmers’ markets? / YES / NOWhich one/s?
Will you be able to continue if you are accepted by Rotary Farmers’ Produce Market / YES / NO
VERIFICATION
The information I have provided is true. If I/We am/are accepted as a stallholder for
the Lilydale Farmers Produce Market I/We will:
- comply with all directions and instructions made by market personnel.
embrace and promote the values of theLilydale Farmers Produce Market
Organised by the Rotary Clubs of Lilydale & Montroseas well as meet
the onsite health and safety issues as directed by the Shire of Yarra Ranges, the market management or other responsible authorities.
- clearly display all prices.
- display my certified organic status and not use the term otherwise.
- not pre-package in plastic bags (unless for health regulations).
- not supply new plastic bags for customers.
- only sell produce and products that are GM free.
- sell loose/in bulk quantities wherever possible.
- will follow the rules referred.
- maintain good relations between all parties concerned with the successful operation of the market.
I/We further agree and understandthat the market is an event from month to month
and in the unlikely occurrence that a market is cancelled, or in the event that the
stallholder is unable to attend a market as previously communicated, the party cancelling
or unable to attend will act in good faith towards the other and give to the other as soon as
possible notice of the same and that in these circumstances neither party will be entitled to
or will claim loss or damage from the other. I/we further agree and understand that
the requirements and rules requiring me/us toembrace and promote the values of the
the Lilydale Farmers Produce Marketmay change from time to time and that I/we will be
notified accordingly.
Signed ______
Date ______
Check List:
Application form for Lilydale Farmers Produce Market
- addressing the criteria and outline of your proposal
(use additional pages if necessary)with a cheque attached for $40.00
- Copy of current Certificate of Insurance or evidence of your product andpublic liability cover
- Application for theShire of Yarra Ranges with a cheque attached
written out to the Shire of Yarra Ranges. (see their rates on the application form)
- P O Box 105 Lilydale Vic 3140 Ph 1300 368 333 Health Dept
MARKET SITE - Cnr Akarana & Swansea Rd Lilydale 3140
8am to 1pm 1st Sunday of each month
Return all applications completed and with the relevant cheques to:-
Lilydale Farmers Produce Market
P.O Box 557 Kilsyth Vic 3137
Eva Anderson Mob:- 0425 222 550
A Project of the Rotary Clubs of Lilydale & Montrose