UNC FARMERS MARKET VENDOR APPLICATION FORM
General Information and Policy for All Vendors
Please read General Information and Policy for All Vendors and Sign Below
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Which farmer's market are you interested in attending?
South Side Farmer's Market (Cedar Ave, Scranton)
Carbondale Farmer's Market (Fallbrook St, Carbondale)
Both
Contact Information
Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email
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example@example.com
Business Information
Business Name
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What will you be selling?
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What social media platforms do you have?
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Facebook
Instagram
None of the above
Do you accept credit cards?
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Yes
No
What other payment methods do you accept?
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Cash
Check
Venmo
PayPal
ApplePay
Other
UNC Markets accept SNAP (Supplement Nutrition Assistance Program, more commonly known as food stamps)
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Yes, I sell food or food producing plants and will accept SNAP.
No, I do not sell food.
INDEMNIFICATION AGREEMENT
INDEMNIFICATION AGREEMENT
The undersigned hereby assume(s) all liability arising from participation as a vendor at the United Neighborhood Special Events. The undersigned do(es) hereby agree to indemnify and hold harmless United Neighborhood Centers of Northeastern Pennsylvania, its officers, directors, agents, employees and volunteers from any and all claims, suits or causes of action (including reasonable attorney’s fees for the defense thereof) brought by any person, firm, corporation, or organization, or the personal representative thereof, arising from your participation as a vendor during special events. By signing below, I accept the space given and will comply with the rules attached to this letter. I also agree to the Indemnification notice above. This applies to all people who attend the market to work on my behalf.
Please read the Indemnification Agree and Sign Below
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Publicity and Photo Release Agreement
Publicity and Photo Release Form UNC NEPA
I, [Your Name], hereby give my consent for the use of my image, likeness, and voice, as well as any quotes or personal information I have shared, in audio or video recordings, or photographs. I understand that this may include editing, copying, exhibiting, publishing, or distributing this material, without any payment or consideration. I acknowledge that these materials may be used for various purposes including conference presentations, educational courses, informational presentations, and agency publicity (such as newspapers, television, social media, brochures, etc.).I understand that my image or story may be displayed electronically on the internet or in educational settings accessible to the public. I will be notified if my photographs or recordings are used for purposes other than those listed above. This release has no time limit and applies globally. By signing this form, I confirm that I have read and understood its contents, and I agree to its terms. I hereby waive any claims against individuals or organizations using this material for educational or agency purposes.
Please read the Publicity and Photo Release Form and Sign Below
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W-9 Requirement
File Upload
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Department of Agriculture Certificate
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Please upload any other certifications you have.
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Upload your product photos below
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