Complete this form to join the Brooklyn, Bronx or Staten Island waiting lists for a Mobile Food Vending Green Cart (Fresh Fruits and Vegetables) permit. Form instructions are on the Health Department website.

Each license holder may submit only one waiting list application.

Your Contact Information

Question Title

* Your Name:

Question Title

* Mailing Address:

Question Title

* Phone

Question Title

* Email address:

Question Title

* NYC Health Department Mobile Food Vendor License Number (8-digits):
You must enter a valid Mobile Food Vendor License Number. Your application will not be accepted if you do not enter a valid Mobile Food Vendor License Number.

Green Cart Permit

Question Title

* Select where you want to operate your Green Cart. ONLY SELECT ONE.
You may only select one Borough. If you submit more than one application, the first application you submit will be selected.

Question Title

* If you fit a priority group, select a group below. Definitions are on the Health Department website. You will be contacted to provide proof of status before your application is entered.

Question Title

* I certify that the information I have provided above is correct. (type your name below)

T