Health & Wellness Food Vendor Application
Business Information
Business Name
Owner/Representative Name
Email Address
Phone Number
Business Address
Website / Social Media
Product Information
Description of Products Offered
Product Category
Fresh Produce
Prepared Foods
Beverages
Supplements
Other
Source of Ingredients
Health & Safety
Certifications (if any)
List of Potential Allergens
Food Handling/Business License Number
Additional Information
Special Requirements / Requests
Comments or Questions