Farmers's Market Payment Form

Vendor Registration Vendor Registration (Payment Link sent after approval) - $25.00

$25.00 Quantity

HU Organization/Club Registration

$ Free Quantity

Food Truck Vendor RegistrationFood Truck Vendor Registration (Payment Link sent after approval) - $100

$25.00 Quantity

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Please list you products below*
Are you a faculty member, student or staff member of Hampton University?*

YesNo
Will you provide food samples*

YesNo
Please upload your Business License

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Please upload your Certificate of Insurance (COI)*

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Please upload your Health Certification (Food and Beverage Vendors Only)

Cancelof
Please verify that you are human*
Should be Empty:

Farmers Market Vendor Payment Form