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2. Gardner Food Truck Festival - Hawker's & Peddlers
4. If you have any questions:
   Contact Maribel Cruz at 978-630-4011
8. Company Name*
9. Contact Name*
11. Email Address*
13. Information for Police Department:
15. If you are doing business under a different name than your company, who are you conducting business as?*
17. Mailing Address*
    Where correspondence should be sent
19. City*
20. State*
21. Zip Code*
25. Property Owner Name*
26. Phone Number*
28. Address*
30. City*
31. State*
32. Zip Code*
34. Emergency Phone Contact 1*
35. Emergency Phone Contact 2
39. Type of Business*
    -- Select One --Sole ProprietorPartnership (including LLP)TrustCorporation (including LLC) Other
43. If you are a Sole Proprietor:
    Only fill out this section if applicable
45. Owner's Name:
46. Date of Birth:
    Date of Birth:
50. If a partnership, trust, or corporation:
    Only fill out this section if applicable
52. Partner/Member/President Name
53. Date of Birth:
    Date of Birth:
55. Address
57. City
58. State
59. Zip Code
61. Partner/Member/ Secretary's Name
62. Date of Birth:
    Date of Birth:
64. Address
66. City
67. State
68. Zip Code
70. Partner/Member/Treasurer's Name
71. Date of Birth:
    Date of Birth:
73. Address
75. City
76. State
77. Zip Code
81. Do you currently have a Massachusetts Hawker Peddler License?*

    1. Yes
    2. No
82. If yes, what is your License Number*
83. Please upload a copy
    Massachusetts Hawker Peddler License
87. Have you or any of your employees been cited by the GARDNER POLICE DEPARTMENT for illegally vending in the City during the past year?*
    -- Select One --yesno
89. Electronic Signature:*
    I hereby state that all information provided on this application is true and accurate, and I understand that any information that is found to be false or misleading will result in the forfeiture of this permit and that I will be required to wait one year before submitting a new application, and that I may be subject to criminal prosecution pursuant to MGL c101. I also understand that any violation of the City's rules and regulations pertaining to Transient Vendors, Hawkers, or Peddlers could subject me to arrest, fine, and/or loss of permit. I also affirm that by typing my name in the above field, I am electronically affixing my signature under the penalties of perjury should any information provided be incorrect.
91. Important Note*

    1. I understand

    A social security number or federal identification number is required for the completion of this application. Maribel Cruz from the Economic Development Office will contact you via phone to get this information. Please do not send this information via email.
Leave This Blank:


93. 1. Receive an email copy of this form.
94. Email address

    This field is not part of the form submission.

95. Submit

* indicates a required field