Name __________________________________________________________________

Address_________________________________________________________________

___________________________________________________ Zip ________________

Business Name __________________________________________________________

E-mail __________________________ Tel _________________ Fax ______________

Product(s) Category: Agricultural__________ Food ___________ Craft(s) __________

Describe the product(s) ___________________________________________________

_______________________________________________________________________

How long have you been producing this product? ______________________________

Will you sell all season (June through the last Thursday in September)?___________

If not, approximately how many Thursdays?______________

Who will sell your product(s)? Name(s) _____________________________________

______________________________________________________________________

Are you familiar with state law regarding sale of food products? __________________

What is your state ID number? _____________________________________________

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I will abide by the regulations of the Hinesburg Lions Farmers' Market

Signed ____________________________________ Date ______________________

Please send completed form to Margery Sharp, PO Box 275, Hinesburg, VT 05461. Thank you.