Form Center

Friday at the Flats Application 2020

2. Business Name*

4. Primary Contact*

6. Address*

8. City*

9. State*

10. Zip Code*

12. Phone Number*

13. Email Address*

15. Mobile Phone*

16. Website or Facebook Link

18. Please list names of employees, partners or family members who will be selling at the market:*

20. What is your preferred method of communication?*

    1. E-mail
    2. Mail
    3. Phone

21. Identify the primary product category that best represents what your business will sell:*

    1. Value-Added Food
    2. Prepared Food
    3. Wine/Hard Cider
    4. Other

23. What products does your business plan to sell?*

    (Please list all products, and be specific. If you plan to resell any products, please provide names and contact information for all farms or businesses where you will be purchasing these products)

25. Check all boxes below that describe your operation and production practices: (*By USDA definition)*

    1. Certified Organic*
    2. Grass Fed* or Grass Finished
    3. Using Organic Ingredients*
    4. Certified Naturally Grown
    5. Free-Range/Pastured
    6. Cottage Food
    7. MAEAP-verified
    8. No Added Hormones, Antibiotics
    9. Other

27. Tell us about your business:*

    Please write a short biography/story (5 sentences), such as your mission, production practices, history, etc. that we can place on the website/Facebook to promote your business.

29. Are you interested in participating in other special events?*

    1. Yes
    2. No

30. Please check the dates you would like to apply to participate in Friday at the Flats below:*

    1. June 12
    2. July 10
    3. July 17
    4. August 21

32. Select each line item to which you agree; leave blank those to which you do not agree (not applicable to your farm or business):*

    1. I have read and understand the Vendor Rules and Guidelines and agree that I and my trained business employees will adhere to them, knowing that failure to do so may result in forfeiture of my table
    2. I plan to resell products (up to 25% of my offerings) from other local growers or businesses to supplement the offerings from my farm or business. I am providing a list of those farms or food business
    3. I will provide copies of all applicable businesses and food licenses with this application
    4. My farm/business has liability insurance for the Portage Farmers' Market. I will provide a copy of my policy when my application is approved
    5. My farm/business does not have liability insurance for the Portage Farmers' Market. I will sign a copy of the "Hold Harmless" agreement when my application is approved
    6. I am willing to complete a vendor profile, provide anonymous weekly sales data, and complete a year-end survey for evaluation purposes to provide valuable data and feedback for the market
    7. I would like to provide samples of my product at the market

34. Please list the product(s) to be sampled:*

36. Electronic Vendor Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. By signing below, you certify that the information provided on this application is true and accurate and pledge that, as a vendor of the Portage Farmers' Market, you will abide by the Portage Farmers' Market Rules and Guidelines.

    1. I agree.
38. Electronic Signature*

39. Date:*
    Date:

43. For Portage Parks and Recreation Staff ONLY

45. Electronic Market Manager Signature

46. Date:
    Date:

48. Electronic Parks Director Signature*

49. Date:
    Date:

Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit Submit and Print

* indicates a required field