Bulli Markets
 
STALLHOLDER APPLICATION
 
I would like to apply for a stall at
BULLI MARKETS
Held on the 2nd Sunday of the Month 9am - 3pm
 
YOUR DETAILS
Business Name
*Phone
  
*Contact Name
Mobile
  
Address
Fax
 
City
Web
  
State
 Postcode
*Email
    * Required Fields 
ABN
  
I am a member of The Market Stallholders Register
PRODUCT DETAILS
Please supply a FULL description of the goods that you wish to sell. 

STALL FEES and POWER
Stall Fees are $40.00 for a 3m x 3m site. I Require site(s)
  I Do Not Require Power I Require Power, approximately Amps ($10.00 Fee)
All extension leads and electrical equipment must be safety checked and tagged.
INSURANCE DETAILS (Mandatory for each Stallholder)
My Public Liability Insurance Details

Insurance Company:
Policy Number:
Expiry Date:
Cover: ($M)
My Product Liability Insurance Details
Insurance Company:
Policy Number:
Expiry Date:
Cover: ($M)
PAYMENT PROCEEDURE: We prefer payment by Electronic Funds Transfer (EFT)
  EFT Bank Details
Account Name:
 KISS Events t/a Bulli Markets
BSB:
 641-800
Account Number:
 2004634448
Reference:
 Your Name or Company Name
Amount Payable
Stall Fees = Number of Sites x $40=
 $
Power (If Required) $10.00 :
 $
TOTAL FEES:
 $
I will be paying by
If sending a Cheque please make it out to BULLI MARKETS and post to us at PO Box 167 Corrimal NSW 2518
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