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HomeMy Public PortalAboutFarmers Market Whole Food ApplicationTOWN OF BREWSTER 2198 MAIN STREET BREWSTER, MA 02631 PHONE: (508) 896-3701 EXT 1120 FAX: (508) 896-4538 BRHEALTH@BREWSTER-MA.GOV WWW.BREWSTER-MA.GOV OFFICE OF HEALTH DEPARTMENT FARMERS’ MARKET WHOLE FARM PRODUCT REGISTRATION FORM Name of Business: ___________________________________________________________________ Business Address: ____________________________________________________________________ Mailing Address: ____________________________________________________________________ Business Phone: ______________________ Fax: __________________________________________ Email: _____________________________________________________________________________ PLEASE LIST SPECIFIC PRODUCTS TO BE SOLD AT THE MARKET: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ I agree to adhere to the Board of Health Farmers’ Market Policy and Conditions for Farmers’ Markets and Farmers’ Market Food Vendors. __________________________________________ ______________ Applicant’s Signature Date Approved ___ Not Approved ___ _______________________________________________ BOH or Health Agent Date