Business Name
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Email
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Phone Number
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(###)
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Primary Contact Name
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Primary Contact Email
Business Mailing Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Federal Tax ID Number (EIN)
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Indicate Your Vendor Type
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Select which dates you are interested in for the pop-up?
FOOD VENDORS: Please Indicate Your Product Offerings For The 2025 Season
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This includes ALL items you either plan to bring OR MAY BRING AT A LATER DATE
NON-FOOD VENDORS: Please Indicate Your Product Offerings For The 2025 Season
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This includes ALL items you either plan to bring OR MAY BRING AT A LATER DATE
Can you provide proof of business insurance?
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If you are a FARMER, can you provide an Extension Agent Certification? *
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If you are a PREPARED FOODS OR SECONDARY PRODUCER, can you provide proof that your products are produced in a licensed commercial kitchen?
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Do you or a member of your staff have a Serv-Safe certification or similar documentation from your local Department of Health?
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Please provide a brief description of your business:
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(NEW VENDORS ONLY) Please describe in detail that products you would like to bring to the PCM and their approximate price points.
(NEW VENDORS ONLY) If you are a value-added or prepared food vendor, please describe in detail your sourcing practices. Wherever possible, PCM encourages its vendors to source locally/regionally.
Please agree to the following:
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