2015 Flavours of Mudgee Stallholder Application

PLEASE COMPLETE THE BELOW STALLHOLDER APPLICATION FORM.

Applications are open to local food and wine producers only.

For entertainment applications please email alayna.gleeson@midwestern.nsw.gov.au

For more information visit www.flavoursofmudgee.com.au

APPLICATIONS CLOSE 14 AUGUST, UNLESS BOOKED OUT PRIOR.

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* 1. Business Name

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* 2. ABN (if applicable)

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* 3. Contact Details

Contact Name: *

Address 1: *

Address 2:

City/Town: *

State:

Postcode:

Email Address: *

Mobile Number: *

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* 4. Type of Stall

Wine

Local Produce

Meals

Cafe/Restaurant

Other (please specify)

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* 5. Products to be sold and/or menu options (does not have to be final, we are just after an indication of what you will be serving to ensure we have a good range on offer).

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* 6. Do you NEED access to power? Please note: access to power is extremely limited and cannot be guaranteed.

Yes

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* 7. Do you have current Public Liability Insurance? All stallholders MUST have Public Liability Insurance. You will be required to provide a current Certificate of Currency.

Yes

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* 8. Stall location requests? Please note: these requests cannot be guaranteed. The event area for 2015 will be slightly different than in previous years. More information will be available shortly.

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* 9. Do you have any comments/questions?

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* 10. Please check the following:

By submitting this form, I agree to pay a non-refundable site fee of $75 plus GST. Payment MUST BE RECEIVED no later than one month prior to the event date.

If, for any reason, I am unable to attend the event, I will contact the organiser as soon as possible to advise on 6378 2850 or alayna.gleson@midwestern.nsw.gov.au.