IAMSE Restaurant Registration
After completing this form, please send an invoice for IAMSE, 1000 5th Ave. Suite 100, Huntington, WV 25701 to lynne16@vt.edu
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Restaurant Name *
Owner Name *
Owner Email *
Owner Phone *
Manager Name *
Manager Email *
Manager Phone *
Signature Tasting
Describe the type of “signature tasting” you plan to serve. Please be as specific as possible, including the size of the portion
Presentation Needs
Describe any special plating or presentation needs: (example, dishes, utensils etc.)
Electrical Needs
Describe any electrical needs you have for this event
VDH Temporary Food Event Permit *
Has your restaurant already paid for a 2019 VDH Temporary Food Event Permit? If so, please email an updated permit and copy of receipt to lynne16@vt.edu
Responsible party for securing VDH permit
If your restaurant has not yet paid for a Temporary Food Event Permit in 2019, who from your restaurant will be responsible for securing the permit by May 6th, 2019 (Download a permit application at https://medicine.vtc.vt.edu/content/dam/medicine_vtc_vt_edu/community/temporary-food-establishment-vendor-application.pdf)
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