Indicates a required field
CONTACT DETAILS
Full Name :
Phone Number :
Mobile Number :
Email Address :
Address :
CONTACT PERSON IN CHARGE OF STALL
Full Name :
Phone Number :
Mobile Number :
Email Address :
Address :
STALL DETAILS (Tables and gazebos will be available for rental from our office)
Start Date :	dd/mm/yyyy
Description of products to be sold :
Please select if you wish to become a Casual or Permanent Stall Holder.	Casual Permanent
Size of Stall Required :	Please nominate number of bays required: Carpark bays measure at 2.5m wide x 5.5m long
Do you require a vehicle on site?	Yes No (Please note that not every stall can have car on site)
Do you require power for your site?	Yes No   (All powered sites will be charged an extra $15.00 in addition to rental fee)
Do you have or need a Temporary Food Stall License from Brisbane City Council?	Yes No    If Yes : License Number: Exp Date : dd/mm/yyyy
Do you have Public Liability Insurance?	At the request of our Insurance Company all Public Liability will be insured by Brisbane North Family Market for an additional $5.00 per week
Is there anything else you would like us to know about your business?