ABOUT YOU

All fields marked with * are required.

Surname*

First Name*

Business Name*

Company Name

ABN or ACN*

Your Address

Street No. and Name*

City/Town/Suburb*

State*

Postcode*

Postal Address (if different)

Phone Number*

Website Address*

Email Address*

ABOUT YOUR STALL

For GOODS stalls, please provide details of products you intend to sell:

For FOOD & BEVERAGE stalls, please provide details of style of menu, pricing, and cuisine speciality:

Please attach photo of product if available (2MB max. jpg, png, or pdf):

Preferred Start Date

PLEASE NOTE: LANA’S FARMERS MARKETS CAN OFFER A RANGE OF DIFFERENT STALL OPERATIONS TO SUIT YOUR INDIVIDUAL NEEDS. CONTACT US FOR FULL DETAILS OF AVAILABLE STALL SIZES, TYPES, AND PRICES.

Please specify any other requirements you will require to operate:

Licensing and Insurance

For food service vendors, please provide a copy of food service/safety certificate for the Bundaberg Region. If you do not have a permit, you must obtain one from Bundaberg Regional Council prior to occupation.

Permit Number:

Attach copy (Max.2MB, pdf, jpg, png)

All stallholders MUST have current public and product liability insurance> Please provide details:

Insurer

Policy No.

Expiry Date

Do you have at least $10 million cover? YesNo

ADDITIONAL INFORMATION

1. Site Power and Usage

2. Set Up and Pack Up Information

All stalls are to be set up and operational by 7 am on day of market trading and closed, cleaned and vacated by 3 pm.

Afternoon stalls are to be operational by 4 pm and vacated and cleaned by 11 pm

Trading days will be:

Friday night 4 pm to Late

Saturday 7 am to 1 pm

Saturday night 4 pm to Late

Sunday 9 am to 1 pm.

NOTE: Lana’s Farmers Markets open on Friday night, Saturday morning, Saturday night and Sunday morning.

3. Payment Information

All hire fees must be in advance for the entire booking period. Hire fees must be paid to LFM in one of the following manners:

Cash

Electronic Transfer

4. Rules

All occupants and visitors of LFM must at all times adhere to any rules and directions of LFM Management. The Rules will be advised by LFM Management.

STALLHOLDER DECLARATION

The Applicant (and where later applicable the Stallholder) states:

I have read and will comply with all Terms and Conditions and Rules provided by LFM.

I hold and will maintain all required insurances and required approvals/permits for the duration of my hire period.

I accept that my occupation on Site can be terminated at any time by LFM if I have breached the Terms and Conditions and Rules.

I declare that I am the person identified in the Applicant details and understand that my digital signature below is legally binding. I understand that it may be an offence to impersonate another individual by submitting an application in their name.

Type Full Name*

Date*

This application is subject to approval and acceptance by Lana’s Farmers Markets. We will be in touch as soon as possible.Thank you for your application.