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Martha's Market At IX Park Vendor Application

Vendor Information

Please indicate Vendor name as you want it to appear at your booth and in print materials:

Full name of person to contact:

Cell phone number of contact person:

Street Address:

City:

State:

Zip Code:

Phone Number (Monday-Friday):

Email:

Website and/or social media URLs:

Business Information

Business Owner Name:

Same as above

Different: Fill in fields below

Owner Name (Full Name)

Street Address

City

State

Zip Code

Business owner's phone number

Business owner's email

What is your business designation:

Sole proprietor

Privately owned by applicant

Franchise operation

Retail chain company

Multi-level marketed, single operator

Provide a two sentence narrative description of your merchandise that we can use for marketing. No bullet points please.

Merchandise Description

Accepted forms of payment - select all that apply:

Credit Card

Mobile device credit (Square, iPad, etc.)

Check

Cash

Other

Methods(s) by which you will manage your accounting:

Receipt Book

Z tape

Square (or similar mobile device)

Other

All information provided in this application is truthful and accurate:

I verify

This application is not a guarantee of participation in Martha's Market:

I understand

Special Vendor Requests

Booth Specifications:

Booths are located in the outdoor central plaza of the IX Art Park. Only the space and a 10x10 tent is provided. Vendor must bring all necessary booth set-up and equipment including tables, chairs, extension cords, etc. Strong Wi-Fi access is provided. Booth fee is $200

Martha's Market Experience:

Martha's Market Participation

First-time applicant

Previously applied, but never a vendor

Previous vendor

List the years you were a Martha's Market vendor:

Martha Jefferson Hospital Foundation

500 Martha Jefferson Drive, Charlottesville, Virginia 22911
Email: MJH_Foundation@sentara.com
Phone: 434-654-8258
Fax: 434-654-7316

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