JefJam Vendor Form

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

* Indicates required field

Email *

I agree to receiving marketing and promotional materials *