Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Business Phone

(###)

###

####

Phone

(###)

###

####

Do you anticipate that you will be a REGULAR (Weekly) Vendor-Permanent Space, or an IRREGULAR Vendor-Floating Space? *

REGULAR Vendor - Permanent Space

IRRIGULAR Vendor-Floating Space.

Do you require a pull-up space? *

Yes

No

Do you require electric service? *

YES Bring at least 100’ cord or more

NO Electricity Needed

Have you been a vendor with the Champaign County Farmers Market in any prior year? *

Yes

No

Additional 10’x10’ vending space may available on a limited basis for members. Each additional 10’x10’ space is $25, and is good for the entire 2024 season. No sharing or subletting to other Vendors.

Yes

Date *

MM

DD

YYYY