| 2012 MARKET DATES |
Site Fees: All sites 4m x 4m unless advised otherwise
General Stallholders: $47 per site
Charities and Community Groups: $35 per site
All power leads have inspection tags attached $20 per lead
Product and Public Liability: Copies of Certificate of Currency must be attached
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Food & Wine Stalls: Copies of Alcohol permits, and food selling approvals from the
Mansfield Shire Council (03 5775 8555) MUST be attached.
Name…………………………………………Trading as…………………………………
MANSFIELD BUSH MARKET INC.
MARKET BOOKING APPLICATION FORM FOR 2012
Market Telephone No: 0417 118 103
Market Time: 8am – 2.30pm
www.mansfieldbushmarket.com.au
Address……………………………………………………………………………………
……………………………………………………………………Postcode………………
E-mail……………………………………………………phone : (……)…………………
Mobile No:…………………………Type of goods………………………………………
Australia Day Weekend : Saturday 28nd January. 2012. Highett Street. Closing date 30 th December 2011
Stall Fee Enclosed: $………………………....
Power Lead ..........x $20 = ...............................
Total Fee Enclosed: $………….....…Office Use Only.......................Invoice No:……………………Site No:…………..
Easter Saturday: Saturday 7 td April. 2012. Highett Street. Closing date 2 nd March 2012
Stall Fee Enclosed: $…………………….
Power Lead .........x $20 = ..........................
Total Fee Enclosed: $………………Office Use Only......... ..... ……Invoice No:……………………Site No:…………..
Queens Birthday : Saturday 9 th June. 2012. Highett Street. Closing date 5 th May 2012
Stall Fee Enclosed: $…………………….
Power Lead .........x $20 = ..........................
Total Fee Enclosed: $………………Office Use Only..........…… .....Invoice No:……………………..Site No:…………..
Melbourne Cup Weekend : Saturday 3 rd November. 2012. Highett Street. Closing date 30th October 2012
Stall Fee Enclosed: $……………………
Power Lead .........x $20 = .....................
Total Fee Enclosed: $……………Office Use Only..........…………...Invoice No:……………………..Site No:…………..
Total fees Enclosed $………………….Cheque/Cash/Money Order (please circle)
I Agree to comply with the rules and regulations of the Mansfield Bush Market Inc.
Signed ………………………………………………………………..
Please include a stamped self-addressed envelope for return of Receipt and Site Plan
Mansfield Bush Market Inc.PO Box 476,Mansfield.Victoria 3724