Casual Stallholder Application

Casual Stallholder Application

    Personal Information

    Stall Holder's Name

    Registered Business Name (if applicable)

    ABN (if applicable)

    Market Stall Name

    Website

    Email Address

    Phone Number (bh)

    (ah)

    Mobile

    Postal Address

    Residential Address while in Broome

    Anticipated Commencement Date at Market

    Broome Residents

    Attach a copy of your driving license and advise your trading preferences

    Please list your town and state of residence:

    How long you intend to trade in Broome:

    Stalls Informations

    Category of Stalls

    Information Stalls

    Stall Size

    Please stipulate the exact dimensions

    Do you use gazebo/tent?

    Do you use a van?

    Do you use Electrical Items?

    Do you use a van?

    List Your Cooking Methods at the Market

    (eg. flames grill, hot plate, deep fryer, etc)

    List Your Cooking Methods at the Market

    (N/A service and information stalls unless you wish to sell supporting products)

    Product Concept/Design

    Product Production

    Note: Preference is given to self-made, local made craft and services, Commercial imported products and franchise based products are subject to approval.

    How will your Stall and Product be Displayed

    Attach photos if available


    Number of People to Run the Stall

    (Note the stallholder listed on this form is required to be the principle person to operate the stall)

    List All Car Registration Numbers for you and Ancillary Staff

    Licenses and Permits

    Relevant Legistative Licenses/Permits

    Certificate of Registration as Food Business (Shire of Broome)

    Public Liability

    Do you Sell Products from a Retail Outlet?


    Attachments

    Contact Information

    Please tick the relevant box/es: I give permission for Broome markets to give out the following

    Consent

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