Name * First Name Last Name Name of Business * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Farm/Production Location, if applicable Phone * (###) ### #### Email * Website http:// Social Media Page @ Description * Please describe your products or service being sold Requested Market days Friday Only Saturday Only Friday and Saturday Electricity Required Please choose yes or no. If yes, 110v or 220v plug? Yes, 110v Yes, 220v No electricity required If electricity required, what equipment will be used? I agree to the $10 extra fee for electricity Yes N/a Emergency Contact * First Name Last Name Federal Tax ID (EIN) Sales Tax ID for Desoto Parish Insurance Company Name and Policy # Food Vendors only If preparing food on-site, do you have a fire extinguisher required by the state of Louisiana? Yes No N/a Health/Food Permit ID # I have read and understand LA Cottage Food Law Compliance Yes N/a I have read and agreed to Brassica Farm Farmers' Market general regulations and have been given a copy * Yes No All of the above information is correct to the best of my knowledge * Please write your name and date Thank you for registering! We can't wait to see you at our market.To confirm your spot, please visit the vendor login page, choose the specific event you'd like to attend, and submit your payment. General Regulations 2025
