SIAC 2022 Health & Safety Community Fair Vendor and Performer Registration Form

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Event: SIAC 2022 Health & Safety Community Fair
Date: Saturday, May 14, 2022
Event Time: Noon- 4:00pm
Set-Up Time: 10:30am
Location: 40 Beach Street Staten, Island, NY 10304 (Eden II Parking Lot, entry at the intersection of Beach Street & Union Place).

Email *

Name of Participating Organization/Business/Performer: *

Representative: *

Address:

Phone Number: *

Fax Number:

Mobile Number:

Website:

What would you like to provide? *

Mobile Unit - Vehicle Dimensions: ____ (H) x ____ (L) x ____ (W)

Table (We do not provide tables)

Demonstration (Please Provide Details)

Giveaways

Refreshments

Performer (include performance details)

Other

Required

What type of organization are you? *

Performer

Non-Profit

Government

Food Vendor

Non Food/ For Profit Vendor

Other:

For Profit Vendor Fee: $25 ($27.22 via PayPal Fee) to help to defray the cost of this community event. *

Pay Here: https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=U9Y5PUP3EWDVC

N/A

Food Vendor Fee : $100 ($108.88 via PayPal Fee) to help defray the cost of this community event. *

Pay Here: https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=52QSY86PCMV4Q

N/A

Whether you are serving or selling food, a food handler license is required. In addition, the NYCDOH reminds all that a Temporary Food Service Establishment (TFSE) permit is also required. All food vendors regardless if they are selling or offering free food or beverages (even water) are required to have a Temporary Food Service Establishment permit. The only exception to this are restaurants that already have a Food Service Establishment (FSE) permit. Their current permit will allow them to operate one booth, stand, table, etc. and all additional booths will be required to have TFSE permits.

Please see the link to apply https://www1.nyc.gov/nycbusiness/description/temporary-food-service-establishment-permit

Food handlers license

Yes

Clear selection

Food Service Establishment (FSE)

Yes

Clear selection

Temporary Food Service Establishment (TFSE)

Yes

Clear selection

Please list all staff that will be representing your organization/business, including contact information:

Submit

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