Stall Holder/Exhibitors Permit

Issued for Council Roads, Council Footpaths or Council Sporting/Recreation Ground Sites

* Mandatory Field

Application Details
Applicant Details
Permit Number

To be completed by the Southern Mallee District Council

Organisation/Business Group Name*
Postal Address*
Email Address*

Please include your Home and Mobile Telephone Numbers

Application To*
Event Name and Dates
Event Name*
Location of the Event*
Date of the Event*
Event Hours*
Event Description
Activity Description*

Please Describe the Activity

Details if Food and Drink are to be Sold

If Food or Drink is to be sold please provide details

Are you a Registered Food Business

If yes please provide the Approval Number and Approving Authority Name

Details if Alcohol is to be Sold

If Alcohol is to be provided or sold please provide details

Details if any Music will be Played

If any Music will be played please provide details

Powered Site

Council will not provide Electricity to the Site if you are providing Electrcity please provide details

Agree with the Terms and Conditions
Stallholder Terms and Conditions*

By ticking this box you are deemed to have read and agree with the Stallholder Terms and Conditions

Click here for terms and conditions

Please attached current copy of your Insurance and any required Licences

Confirmation of the Attached Documents*

Please confirm you have attached the documents as outlined in the Terms and Conditions

If you see this, leave this form field blank.

Send a copy of the submitted form to this email address.