| * Your Name : |
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| * Address : |
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| ** Phone Number : |
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| ** Mobile Number : |
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| ** Email Address : |
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| * Preferred method of contact : |
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| Business Name : |
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| Business Address : |
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| ABN : |
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| * Are you a : |
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| NSW Food Authority Registration Number : |
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| NSW Food Authority Registration Expiry Date : |
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Where else is your product sold? (please list other markets or retail outlets)
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Please provide a brief history of your property or business.
(for example, how long have you been involved, if it's a family property etc)
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Please list the products you grow or produce that you intend to sell now.
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Please list the products you grow or produce that you intend to sell in the future.
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Do you have any certifications? (e.g. Certified Organic).
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Are you planning on becoming certified in the future?
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* Please indicate your preferences for a SCPA Markets site :
* See the Market Rules and Policy on the Information for Stallholders page.
Only those who attend fortnightly can obtain a permanent site. |
Do you require power? ($5.00 per market) :
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| How often will you attend? : |
Weekly:
Other : |
Your preferred start date? :
(Subject to Market Coordinators approval) |
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* Tick to agree to the statement below.
I have read and will comply with the Bega Produce Markets rules and changes to those rules as notified to me from time to time by the Marker Coordinator.
I currently hold and will keep current all necessary NSW Food Authority Certificates (where appropriate)
I currently hold and will keep current all necessary insurance cover
I authorise the Market Coordinator to verify any of the information provided, including visiting my property or, if an agent, the property of the primary producer.
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* Required Fields
** At least one is Required
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