Stallholder Application

First Name:*

Last Name:*

Business Name (if applicable):

Position in Business:

Phone:*

Cellphone:

Email*

Website

Physical Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is your postal address different to the physical address above?*

Yes
No

Postal Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Items for Sale

Please supply detail of the item(s) you wish to sell at the Bay of Islands Farmers Market.

Item Catagory*

Please select the best fit for you item(s).

Fresh Produce
Value Added (for growers who process their surplus produce)
Artisan
Food Prepared on Site

Produce List

Please list all produce/products and then indicate which months they will be avaliable.

#1 - Produce

#1 - Avaliable

#2 - Produce

#2 - Avaliable

#3 - Produce

#3 - Avaliable

#4 - Produce

#4 - Avaliable

#5 - Produce

#5 - Avaliable

#6 - Produce

#6 - Avaliable

#7 - Produce

#7 - Avaliable

#8 - Produce

#8 - Avaliable

#9 - Produce

#9 - Avaliable

#10 - Produce

#10 - Avaliable

Where is your produce grown?*

Physical Address (listed above)
Postal Address (listed above)

(If other than your own property, please give details and attach copy of relevant agreement eg. Lease)*

File

Accepted file types: jpg, png, pdf, Max. file size: 512 MB.

Do you have any industry certification eg. GAP, Certified Organic?*

Yes
No

Please provide details and a copy of certificate/registration*

File

Accepted file types: jpg, png, pdf, Max. file size: 512 MB.

Value Added / Artisan / Food Prepared on site

This section is for VALUE ADDED (for growers who process their surplud produce) / ARTISAN / FOOD PREPARED ON SITE.

Please list each item you wish to sell:*

Where are the ingredients sourced; is your product representing what's locally available?*

Where is the product processed/prepared and by whom?*

Is the facility registered for the preparation of food for sale to the public?*

Yes
No

Do you have a licence for this? (eg. commercial kitchen, mobile shop)*

Yes
No

Please provide details and upload a copy of the licence:*

File

Max. file size: 512 MB.

For information regarding compliance with food safety regulations please contact the Environmental Health Officer 0800 537 4342

All Applications

How frequently do you intend to sell listed product(s) at the market?*

Is this application for:*

Kerikeri
Paihia
Both markets

Do you require power at your stall?*

Yes
No

Please provide any further information that you feel may be relevant to this application:

Comments

This field is for validation purposes and should be left unchanged.