Portage County Health District Thriving Together Farmers' Market Vendor Application Survey

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* 2. Contact Name

First Name

Last Name

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* 3. Address

Street Address

Apartment, Suite, Unit, etc.

City

State

Zip Code

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* 4. Phone Number

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* 5. Email

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* 6. Website and social media links

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* 7. Please select all products from this list that you plan to bring to the market

Fruits, Vegetables and/or fresh herbs

Acidified foods

Annual seedlings

Baked goods that do not require refrigeration

Baked goods that require refrigeration

Coffee beans

Cut flowers

Dairy products

Dried herbs

Dried tea

Eggs

Farm crafts

Fruit preserves

Granola

Honey

Maple syrup

Meat

Nursery stock

Popcorn

Ready-to-eat food and/or beverages

Service

Other (please specify)

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* 8. Please upload any food or nursery licenses you have including, but not limited to: Mobile Vendors, Ohio Department of Agriculture, Registered Food Establishment, or Nursery Inspection Certificates

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* 9. Do you produce your product in a Certified Commercial Kitchen or Food Processing Establishment?

Yes

Not applicable (I am only selling fruits, vegetables and/or fresh herbs)

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* 10. Are all foods or food products that you are selling produced on your farm?

Yes

Not applicable

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* 11. Do you plan to attend the market each week?

Yes, I will attend every Tuesday from June 17 until September 9

No (enter dates you would like to attend)

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* 12. Select your vendor payment rate.

Weekly: $15 per market, due weekly

Monthly: $36 per month, due at the first market of each month

I am selling fruit, vegetables and/or fresh herbs (fee waived)

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* 13. I agree to follow market guidelines (e.g., arriving on time, selling designated items, etc.)

Yes

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* 14. Please type your name below to sign this application.

Typing your name below certifies that all information being submitted is true to the best of your knowledge, and that you consent to electronic signature of this application.

Portage County Health District
Thriving Together Farmers' Market Vendor Application

Thank you for your interest in attending our farmers' market!

Question Title

* 1. Business Name

Question Title

* 2. Contact Name

Question Title

* 3. Address

Question Title

* 4. Phone Number

Question Title

* 5. Email

Question Title

* 6. Website and social media links

Question Title

* 7. Please select all products from this list that you plan to bring to the market

Question Title

* 8. Please upload any food or nursery licenses you have including, but not limited to: Mobile Vendors, Ohio Department of Agriculture, Registered Food Establishment, or Nursery Inspection Certificates

Question Title

* 9. Do you produce your product in a Certified Commercial Kitchen or Food Processing Establishment?

Question Title

* 10. Are all foods or food products that you are selling produced on your farm?

Question Title

* 11. Do you plan to attend the market each week?

Question Title

* 12. Select your vendor payment rate.

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* 13. I agree to follow market guidelines (e.g., arriving on time, selling designated items, etc.)

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* 14. Please type your name below to sign this application.

Typing your name below certifies that all information being submitted is true to the best of your knowledge, and that you consent to electronic signature of this application.

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* 15. Thank you for applying! We will follow up with you as soon as we can. Is there anything else you would like to add?

Portage County Health District Thriving Together Farmers' Market Vendor Application

Thank you for your interest in attending our farmers' market!

Question Title

* 1. Business Name

Question Title

* 2. Contact Name

Question Title

* 3. Address

Question Title

* 4. Phone Number

Question Title

* 5. Email

Question Title

* 6. Website and social media links

Question Title

* 7. Please select all products from this list that you plan to bring to the market

Question Title

* 8. Please upload any food or nursery licenses you have including, but not limited to: Mobile Vendors, Ohio Department of Agriculture, Registered Food Establishment, or Nursery Inspection Certificates

Question Title

* 9. Do you produce your product in a Certified Commercial Kitchen or Food Processing Establishment?

Question Title

* 10. Are all foods or food products that you are selling produced on your farm?

Question Title

* 11. Do you plan to attend the market each week?

Question Title

* 12. Select your vendor payment rate.

Question Title

* 13. I agree to follow market guidelines (e.g., arriving on time, selling designated items, etc.)

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* 14. Please type your name below to sign this application.Typing your name below certifies that all information being submitted is true to the best of your knowledge, and that you consent to electronic signature of this application.

Question Title

* 15. Thank you for applying! We will follow up with you as soon as we can. Is there anything else you would like to add?

Portage County Health District
Thriving Together Farmers' Market Vendor Application

* 14. Please type your name below to sign this application.

Typing your name below certifies that all information being submitted is true to the best of your knowledge, and that you consent to electronic signature of this application.