Keller Market | Vendor Application

Business Name*

Contact Name*

Contact Title*

Mailing Address*

County*

Main Phone Number*

Cell Phone Number*

Please re-enter the main phone number if it is the same as your cell phone number.

Email Address*

PRODUCTION LOCATION

If your product is grown or produced at an address other than the one provided above, please provide the production location information below, starting here with the Location Name:

Production Location Address

Owner / Manager Name

Owner / Manager Cell Phone

Owner / Manager Email Address

License(s) Facility Holds:

Please select the Product Categories you would like to sell:*

Produce
Animal Products
Wild-Crafted and Foraged
Nursery Products
Value-added
Non-Food Agricultural
Personal & Body Care
Artisan

Please list the products you would like to sell at Keller Market House:*

Please indicate which licenses and/or certifications are required and/or held for your products:*

Vendor’s License
Organic Certification or Certified Naturally Grown
ODA License(s)
Health Department License(s)
Other

Please upload your licenses and certifications here:

Each file can be no larger than 8 MB. The type of files you can upload are: PDF, .jpg or .jpeg

Drop files here or

Accepted file types: jpg, jpeg, pdf, Max. file size: 100 MB.

Delivery Schedule*

Please choose the days you will deliver product to the Market. Note: we are open Tuesday - Saturday for deliveries.

Tuesday
Wednesday
Thursday
Friday
Saturday

How often will you deliver to us?

FARMERS ONLY - Please identify production practices that apply to you:

Certified Organic
Pasture-Based Livestock
Non-GMO Feed
Non-GMO Seed
GAP Certified
100% Chemical-Free Practices
No Use of Sub-Therapeutic Antibiotics
Integrated Pest Management
Other Practices (name below)

If you selected ‘Other Practices’ above, please share them here:

COTTAGE FOOD VENDORS ONLY

Please upload a sample of your label graphic - only one is required.

Accepted file types: jpg, jpeg, gif, tiff, png, pdf, Max. file size: 100 MB.

ARTISAN VENDORS ONLY

Please upload at least three pictures representative of your work for our artisan jury. An active website or social media account displaying such pictures is also acceptable - these addresses can be provided below.

Drop files here or

Accepted file types: jpg, jpeg, gif, tiff, png, pdf, Max. file size: 100 MB.

Keller Market Producer Agreement*

By my submission of this online Producer Application, I certify that:

I have read and understand the Keller Market House Guidelines, Rules & Procedures.
I agree to comply with the Keller Market House Guidelines, Rules & Procedures. Failure to comply with these standards may result in the termination of my relationship with Keller Market House.
I understand that all products must comply with all applicable federal, state and local health regulations.
I understand that I may only bring in approved products, and that if I wish to bring in additional products, they must be approved by market management prior to placement within the market.
I aﬃrm that all information in this application is complete and accurate.
I understand Producer Agreements may be terminated at any time by either the Producer or the Keller Market House.

Typed Signature of Person Completing this Form:*

Date of Submission

Keller Market Producer Application