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Vendor Form
**this form should only be submitted once registration fee(s) have been paid**
*
Indicates required field
Company Name
*
Contact Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Emergency Number
*
Email
*
type of business
*
Food
Merchandise
Informational
Other
If other, explain here
*
List all items you plan to sell
*
How many 10x10 spaces? ($25 each)
*
Need Electric? (+ $10)
*
Yes
No
CLICK HERE
for terms & guidelines on becoming a vendor.
I have read and agree to the terms and guidelines presented by Jefjam
*
Yes
I HAVE PAID A VENDOR REGISTRATION FEE
*
Yes
If not,
click here
to pay.
I have a valid jefferson county peddler's license
*
Yes
If not, contact
(636.797.5406) and acquire license before submitting form.
*FOLLOWING QUESTION IS FOR FOOD VENDORS ONLY*
I have have a license from the Jefferson County Health Department
*
Yes
If not, contact (636.789.3372) and acquire license before submitting form.
Submit
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