Contact Name *

First Name

Last Name

Business Address or Residence - Not published *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Phone Number *

(###)

###

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Vendor Primary Category *

Please read description and select only one

Grower - Fruits & Vegetables, All produce must be harvested within 100 miles of Ft. Wayne, IN. by the producer applying

Agriculture - Coffee, Tea, Honey, Wine, Maple syrup and eggs.

Rancher - sells meat from; Chicken, Cows, Goats, Pigs, Duck, Turkey, ETC....

Certifications *

“We place priority on vendors who hold at least one of the following certifications: Certified Naturally Grown, certified organic or humane certified. Please indicate if you hold a certification, and provide a copy of your most recent certificate with your application.”

None

National Organic

Certified Naturally Grown

Certified Humane

Other

Organizations or Certifications your business belongs to *

Market Maker

Indiana Grown

Indiana Artisan

Indiana Originals

Greater Fort Wayne

None

Other

Indoor 23/24 participation *

Oct 5 through May 2024

Yes - Full/Part time

Guest - sporadic

No

Summer participation *

yes

no

Summer Wednesday 3-7 Participation *

Starts June 12th at Electric Works

Yes

No

Guest

What other days could you do a year round indoor market

As we expand what days would you be available to be at Electric Works

Monday

Tuesday

Thursday

Friday

Sunday

None

Do you want to accept SNAP benefits from your customers? *

You will receive a check to be deposited into the bank from the customer. You can deposit them after your business is approved by our sponsor.

yes

no

Do you sell Eggs? *

If yes, you will need to provide a copy of your license.

Yes

No

Will you bring a scale to weigh product *

Yes

No

Do you sell non food items? IE: flowers, plants, beeswax *

If yes we will need a copy of your Retail Merchant Certificate.

Yes

No

Do you plan on sampling food? *

If Yes, we will need a copy of your ServSafe. If you don't have one we can assist you with a discount for the food handler certificate.

Yes

No

Do you have any items that require temperature control? *

If you need to keep an item cold to for the safety of the product, we will need a copy of your Farm Market permit from Allen County Board of health

Yes

No

Will you be sampling or serving alcohol/wine *

Yes

No

Once accepted, I will provide liability insurance for participating in the FWFM. *

Liability insurance is needed for anyone selling a edible item or item that goes on to a person's body such as soap. Covers damages that may occur at Parkview Field or at the Barr Street location while operating as a business. This protects your family and it's financial stability. Please email with any questions

Yes

Once accepted, I have or I am willing to get a Retail Sales Certificate . *

Indiana State law states that any non food item will collect sales taxes. Also any food item deemed ready to eat also collects sales tax: IE if a vendor makes available eating utensils, napkin or unsealed container: the food is deemed ready to eat.

yes

No - I sell non taxable item.

Select the ones you are certified or trained in. *

First Aid

CPR

AED

Crowd Control

Emergency response/management

None

I agree *