This form is for Special Event Vendors. Please complete and submit this form at least 30 days prior to the event. If you are an event organizer, please refer to our general Special Event information page. Mobile vendors already licenced by the local municipality and inspected by the Wellington-Dufferin-Guelph Public Health Unit are not required to submit a Special Event Vendor Form. Event Information Event Name * Event Location/Address * Expected Attendance * Under 800 Over 800 Event Start Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202020212022 Event End Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202020212022 Is this an annual event? * Yes No Vendor Information Business Name * Contact Name * Contact Email Address * Contact Business Phone * Business Address * Street Number and Name City * City Postal Code * Postal Code Website Are you an inspected facility? * Yes No Will a certified food handler be on site? * Yes No Type of set up at event * Preparation/serving kitchen Temporary booth/BBQ Mobile vehicle (food truck) Cart (hot dog or other) Food Information State each menu item, its source/supplier and location of preparation. No home preparation is permitted. Food menu item*Source of food/supplier*Location of food preparation*Edit Food menu item * Source of food/supplier * Location of food preparation * Food Handling/Storage How will food be transported to the event? (check all that apply) * Refrigerated truck Thermal Unit Coolers or insulated bag with ice Other (specify): Specify Other (if applicable): How will food be reheated (to a minimum of 74 degrees) prior to service? * A probe thermometer must be available on site to ensure proper internal food temperatures. Describe your potable water source * Please ensure you have potable water and waste containers available. Describe your handwashing station * Liquid hand soap in a dispenser and paper towels must be available for use. Dishwashing Method How will you ensure a clean supply of your pots, pans and cooking utensils? Check all that apply * Cleaning and sanitizing dishes with a 2 compartment sink Cleaning and sanitizing dishes with a 3 compartment sink Extra cooking utensils What sanitizer will be used? * Chlorine bleach QUAT Iodine Other (specify): Specify Other (if applicable) Multiple Events If you are attending more than one event in the Wellington-Dufferin-Guelph region, input the names of the upcoming events below. Application forms are not required for these additional events. Event nameEdit Event name Floor Plan (Optional) Upload a floor plan. Upload a floor plan (optional) Files must be less than 2 MB.Allowed file types: gif jpg jpeg png pdf doc docx. Comments (Optional) Any additional comments (optional) CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.