Food Vendor Application

All food vendors must provide a copy of their food permit. If you do not have one, please contact the Mississippi State Department of Health.

Individual or Business Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

Type of Food Vendor:

Space Needed:

10x20 - $200

20x20 - $300

List All Menu Items and Pricing (if available):

Additional Information: