Village of Chittenango

             Artisan and Farmers Market Application

 Complete & return to: Village of Chittenango Artisan/Farmers Market

                                    222 Genesee St Chittenango, NY 13037         

              attn: Artisan/Farmers Market or email to


(Please Print Clearly)


 Name ______________________________________________________________________________

 Business Name__________________________________________________________


City _________________________________________ State:   NY    

Zip Code _____________

email address: __________________________________________________________


Contact Phone # ________________________________

cell __________________________________________


product(s) description- ________________________________________________________________________

________________________________________________________________________ Are 60% of these items hand-made/produced or grown by the applicant?  Yes______    No_____                                                                                           


You must comply with NY State and Madison County health codes for any products sold for consumption. Applicable certificates, licenses etc. must be displayed by vendor.


The Market Committee reserves the right to approve/select participating vendors upon receipt and review of your application.


You must agree to the rules and regulations of our market.  Please read them and initial here ____________ that you have done so.

I hereby certify that the information completed above is true and accurate. I further understand that any applicant who makes false statements or representation of certification in this application shall be subject to the revocation of their permit. Date:___________

Signature of authorized party:___________________________________