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Market Application Form 2011

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Market Application Form 2011 Powered By Docstoc
					        Duck Pond Market Application Form

Administrative Details and Stall Holder Requirements (refer to stall holder requirements
on page 3 before completing the form).
Name of applicant:

What is the applicant e.g. Company,
partnership, individual?
Address of applicant including
postcode:




Contact telephone numbers (landline/
mobile)

Email address

Details of your stall, including website
address.
What is the range of goods you intend
to sell? Are these handmade, local,
organic, fair trade, charitable, unique or
specialty? Why are these deserving of a
stall?
Are you a stall holder at other markets?

Which market are you applying for?

Would you be selling at the market all
year round?
If no, what months would you want to     J F M A M J J A S O N D
sell at the market? (tick)
Health, Safety and Environment
Are you proposing to sell food or drinks
that you have prepared or will prepare?
Y/N
If so, please provide details and
documented evidence of competence
in food hygiene e.g. photocopy of a
basic food hygiene certificate


                Email duckpondmarket@me.com or call 07887 850 477
                             www.duckpondmarket.co.uk
                Caron Pook, 117 Swakeleys Road, Ickenham, UB10 8DH
Do you currently have Public Liability
and Third Party Insurance? Y/N
If so, please provide details and
documented evidence of insurance
e.g. photocopy of certificate. (You are
required to prove that you have valid
Public Liability and Third Party Insurance
in order to operate a stall at the market.
When your current policy expires, you
must ensure that you provide the
market manager with evidence of
renewal and hold a copy of the policy
at the stall.)
Do you propose to use gas cylinders or
bring other fuel to the site? Y/N
If so, provide details of safety
precautions you propose to use.
Will there be high temperature surfaces
or equipment at your stall? Y/N
If so, provide details of the equipment
and safety precautions you propose to
use (for
your employees and others).
Will you generate any waste water at
your stall? (E.g. from washing of hands,
knives,
chopping boards.) Y/N
If so, how do you propose to deal with
this?
Will you be bringing any fire
extinguishers with you to the site? Y/N
What other safety hazards, waste
management and effluent issues
associated with your stall are you aware
of that require to be managed? How
should these be managed? (Detail how
you intend to manage these.)
Detail any qualifications or training in
first aid that you have?

Are you or anyone who may work for
you, registered as disabled? Y/N
If so, detail requirements for access. (This
is in order that these can be factored


                Email duckpondmarket@me.com or call 07887 850 477
                             www.duckpondmarket.co.uk
                Caron Pook, 117 Swakeleys Road, Ickenham, UB10 8DH
into the
planned market layout.)
Are you willing to prepare and clearly
display for the public information on
your produce and production
methods? Y/N
Are you willing to prepare and clearly
display for the public information on
how to use your produce e.g. recipes or
serving suggestions? Y/N
Detail any suggestions you have for
marketing of the market?


Market Branding, Customer Service and Data Protection
I consent to allow my services and
contact details to be published on the
Duck Pond Market website. Y/N
If unsuccessful, I consent that my data is
retained and I am placed on the
waiting list for stalls. Y/N
Stallholder Requirements
To participate at the market, you need
to meet one of the following criteria:
     Organic – producers of organically produced agricultural products.
     Speciality – a distinctive product whether foodstuff or craft that is not readily
       available in that form from other retail outlets.
     Grown, reared or caught by the stall holder.
     Brewed, pickled, baked, smoked, or cooked by the stall holder using at least one
       ingredient that is grown, reared or caught by the stall holder.
     Made or created in significant part by the stallholder this applies to craft, organic
       and speciality goods.
     Have a charitable or fair trade status.
     Comply on an ongoing basis with all applicable legal requirements. (It is your
       responsibility to be legally compliant whether or not advice is provided by the
       Market.)
     Provide a first aid box equipped to deal with foreseeable accidents that could
       arise at your stall.
     Hold valid Public Liability and Third Party Insurance.
     If selling prepared food or preparing food, hold evidence of competence in food
       hygiene.
     You or anyone working at your stall is not allowed to smoke at the stall. (Smokers
       can smoke away from the stall.)
     You are required to remove all waste, including both rubbish and waste water,


               Email duckpondmarket@me.com or call 07887 850 477
                            www.duckpondmarket.co.uk
               Caron Pook, 117 Swakeleys Road, Ickenham, UB10 8DH
        generated from the site.
Rent and Direct Debit Details
Pitch rental is £20 per regular sized pitch, £30 per bay pitch at Ruislip, payable in
advance, 1 week prior to the date of the market. Payment later than one week before
the market will incur extra £5.
You are required to pay rent in advance for your stall by direct debit, cheque or bank
transfer.
Payment can be made by cheque or cash. Cheques are payable to
C Pook, and can be posted to 117 Swakeleys Road, Ickenham, UB10 8DH a receipt will
be available on market day.
Bank transfers can be made to:
Co-Operative Bank
Miss C Pook
08-93-00
0532 1577
Please use your name and the date of the market as a payment reference.
Refunds are available for non-attendance. (The market manager must be informed in
writing either by e-mail or letter to arrive seven days in advance of the market. If
insufficient notice is given, stall holders will be charged rental. Refunds are in the form of
credit to attend future markets.)


Declaration
I undertake to read, complete and comply with:
     All applicable legislation including food safety legislation.
     Stallholder Requirements specified in this application form.
     Any other guidance documents that may be provided.
     The selection of traders at the Duck Pond Market will be at the sole discretion of
      Duck Pond Market.
Signature:

Print Name:

Date:



                                 Check before you post.
            Have you included payment for the market you plan to attend?
           If so, have you stated the date of the market you’d like to attend,
                                        clearly?
               Have you included a copy of your public liability insurance?
           Have you included photos or a website to enable a decision to be
                             made about your attendance?
                               Thank you, I will be in touch!

                Email duckpondmarket@me.com or call 07887 850 477
                             www.duckpondmarket.co.uk
                Caron Pook, 117 Swakeleys Road, Ickenham, UB10 8DH
Email duckpondmarket@me.com or call 07887 850 477
             www.duckpondmarket.co.uk
Caron Pook, 117 Swakeleys Road, Ickenham, UB10 8DH

				
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