HomeVendor Application Vendor Application 2023 Name(Required) First Name Last Name Email(Required) Business Name(Required) Address(Required) Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Business WebsiteLink to your business website, if applicable. FacebookLink to your business Facebook page, if applicable. InstagramLink to your business Instagram account, if applicable. Your phone number (for admin)(Required)What phone number should our Market Coordinator use to contact you? This number will not be shared on our website.Business phone number (for customers)What phone number would you like to share with customers? This number may be shared in our vendor directory.Upload Photo / LogoPlease share 1-2 images (photos or logo) that we can use on our website and social media. Drop files here or Select files Accepted file types: jpg, jpeg, png, Max. file size: 128 MB, Max. files: 2. Emergency Contact(Required)Who should we contact in case of emergency? First Name Last Name Emergency Contact Phone(Required)What is your emergency contact's phone number?Which farmers market day(s) are you applying for?(Required)Please select which market days you would like to attend this season: Saturdays only, Wednesdays only, both Saturday AND Wednesday, or individual days. Saturday Market Seasonal: $265 ($380 for two stalls) - due in full Wednesday Market Seasonal: $120 ($175 for two stalls) - due in full Both Sat/Wed Seasonal: $335 ($510 for two stalls) - due in full Daily Vendor: $9 for Wednesday / $14 for Saturday - due each market attended If applying as a Daily Vendor, please list the dates you would like to attend:(Required)Please list dates from May-October, e.g. Sat. 5/6, Wed. 6/17, etc.Which categories of products will you bring to the market:Select all categories that apply. If you do not see your category, select "Other" to add more information. Vegetable Vegetable (Organic) Fruit Fruit (Organic) Meat Meat (Organic) Dairy Dairy (Organic) Flowers & Plants Baked Goods Baked Goods (Gluten-Free) Crafts & Arts Other Other product categories: List all possible products/items you will be selling at the market(Required)Please write a short description of your products/business to be posted on our website, marketing, and weekly emails:(Required)List all persons who will represent your business at the market ("vendor personnel"):(Required)Additional InfoPlease check any of the following that apply to your business: CSA available Online shopping available on your website Customers can shop at your business location Business License - required(Required)Provide a copy of your business license or documentation / proof you are a business (EIN, LLC, DBA, etc.)Accepted file types: jpg, png, pdf, jpeg, Max. file size: 128 MB.Selling Licenses Depending on the product(s) you sell, you must attach copy(s) of licenses and certifications required by Operating Guidelines. Check the attached appropriate non-shaded boxes for each product category you sell and provide the date of the last Health Inspection. Which selling licenses, certifications, or documents are are you uploading?(Required) Organic Certification - Produce or Meat/Eggs/Poultry Sales Tax License - Flowers/Plants/Trees or Artisans Nursery Stock or Growers License Food Establishment License - Processed / Baked Goods Food Warehouse License - Meat/Eggs/Poultry Health Inspection documents None - No food establishment license required, as the business qualifies under 2010 Michigan Cottage Food Law Note: A Health Inspection may be required on all products such as baked goods (Cottage Food exempt), candy, cider, poultry, honey, etc. The Health agencies that govern this market operation are: Washtenaw County Environmental Health: http://www.ewashtenaw.org and Michigan Department of Agriculture: http://www.michigan.gov/mdard Copies of any inspections by these agencies and licenses must be attached with a sample of your label.Organic Certification License Drop files here or Select files Accepted file types: jpg, png, pdf, jpeg, Max. file size: 128 MB. Sales Tax License Drop files here or Select files Accepted file types: jpg, png, pdf, jpeg, Max. file size: 128 MB. Nursery Stock or Growers License Drop files here or Select files Accepted file types: jpg, png, pdf, jpeg, Max. file size: 128 MB. Food Establishment License Drop files here or Select files Accepted file types: jpg, png, pdf, jpeg, Max. file size: 128 MB. Food Warehouse License Drop files here or Select files Accepted file types: jpg, png, pdf, jpeg, Max. file size: 128 MB. Health Inspection Documents Drop files here or Select files Accepted file types: jpg, png, pdf, jpeg, Max. file size: 128 MB. Date of last health inspection (if applicable) By signing below, I certify that I have read and understand the Operating Guidelines and that all licenses and certification listed above are current and valid. I understand that should I, or any vendor personnel fail to comply with the Operating Guidelines, my participation in the Chelsea Farmers Markets can be terminated. As a vendor wishing to participate in the Chelsea Farmers Markets, I along with vendor personnel agree to save, hold harmless and indemnify the markets and property owners from any and all liability or responsibility pertaining to any damages to person or property on the site assigned to me (us) by the market, when such damages or liability arise out of acts of my own or my vendor personnel.Acceptance(Required) I have read and understand the Operating Guidelines and that all licenses and certification listed above are current and valid.Signature(Required) Reset signature Signature locked. Reset to sign again NameThis field is for validation purposes and should be left unchanged.
