Farmers Market Farm Vendor Payment Name(Required) First Last Company Name or DBAEmail(Required) Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Season - Wednesdays & Saturdays Quantity Price: $275.00 Quantity Season - Wednesdays only Quantity Price: $225.00 Quantity Season - Saturdays only Quantity Price: $225.00 Quantity Daily Farm Vendor Fee QuantityEnter the quantity of dates that you have been approved for by Farmers Market staff. Price: $25.00 Quantity Special Allowance Farm Vendor Fee Quantity Price: $50.00 Quantity Payment will be completed using(Required) PayPal Check sent by mail Please make checks out to: Sheboygan County Interfaith Organization To complete your payment, please mail the check to: SCIO Attn: Farmers Market PO Box 73 Sheboygan, WI 53082Total