Page 1 - Health Application - Temporary Food - Community Groups ONLY

* indicates a required field.

Disclaimer: No fees will apply for community and charitable groups. This is not a grant application.

This online form is for Community/Charitable groups only and must be submitted at least 10 days prior to the event.

Applicants First Name *

Must be at least 1 character.

Applicants Surname *

Must be at least 1 character.

Organisation or Community Group Name *

Applicant Position

Organisation Address *

Return to address search

Address line 1

Address line 2

Suburb/Town	State/Province	Postcode

Country

Address Line 1, Suburb/Town, State/Province, Postcode, and Country are required.

Postal Address *

Return to address search

Address line 1

Address line 2

Suburb/Town	State/Province	Postcode

Country

Address Line 1, Suburb/Town, State/Province, Postcode, and Country are required.

ABN

The ABN provided will be used to look up the following information.

Click Lookup above to check that you have entered the ABN correctly.

Information from the Australian Business Register
ABN
Entity name
ABN status
Entity type
Goods & Services Tax (GST)
DGR Endorsed
ATO Charity Type	More information
ACNC Registration
Tax Concessions
Main business location

Must be an ABN.

Is your organisation incorporated?

Yes

Clear

Email *

Must be an email address.

Phone Number *

Must be an Australian phone number.

Details of Site Manager or Person in Charge (if different from applicant) (Not Applicable)

Full Name

Position

Phone Number

Must be an Australian phone number.

Date of Event (Not Applicable)

Date of Event *

Must be a date.

Start Time *

What time will your event begin?

Finish Time *

What time will your event conclude?

If this event is more than one day, please provide other dates or further information:

Details of Proposed Food Handling (Not Applicable)

Types of food preparation/handling *

Response required.Response required.

Low risk - prepackaged foods from an approved food business or an approved home food business e.g. low risk cakes, biscuits, breads, jams and preserves, drinks

Medium risk - fresh or packaged ingredients obtained from an approved food business ready for preparation or use e.g. Sausage sizzles, reheating pies and pizzas

Medium to high risk - foods prepared at an approved food business for onsite cooking or reheating e.g. meat curries

Clear

At least 1 choice must be selected.

Provide further details on food and drink products

Food Stall Details (Not Applicable)

Name of Event

Is this a mobile food vehicle/unit or temporary food stall? *

Response required.

Mobile food vehicle/unit

Temporary food stall

Clear

Address of the temporary premises (where event is held) *

Return to address search

Address line 1

Address line 2

Suburb/Town	State/Province	Postcode

Country

Address Line 1, Suburb/Town, State/Province, Postcode, and Country are required.

Mobile Food Business Details (Not Applicable)

This section is not applicable because of your response to question: "Is this a mobile food vehicle/unit or temporary food stall?" on page 1

Vehicle registration number

Make and model of mobile food vehicle

Attachments to be provided (Not Applicable)

Attach copy of public liability insurance cover - ensure it is valid on date of the event *

Attach a file:

A minimum of 1 file must be attached.

Attach copy of stall plan and site plan *

Attach a file:

A minimum of 1 file must be attached.

Attach copy of food handler's food safety training certificate

Attach a file:

It is highly recommended that you complete food safety training to ensure you are providing safe food for the community. The Foodsafe Training Program is available online for free. Use Use the City's unique discount voucher "FSKWINA344" on the payment page to receive FoodSafe Online free of charge.

Attach copy of food business registration certificate (if registered with another Local Government)

Attach a file:

Attach approval from owner of land (if not on Local Government Land)

Attach a file:

Declaration (Not Applicable)

I certify that to the best of my knowledge the statements made in this application are true.
I understand that if the City of Kwinana approves the application, I will be required to comply with the conditions of the approval.
I consent to the information contained within this application being disclosed to or by the City for the purpose of assessing, administering and monitoring my current and any future applications.
I understand that if the City approves the application, I will be bound by the contents of my application to carry out the stall as I have described.

I agree to the above *

Response required.

Yes

Clear

Applicant Name

This information will help the City's Graphic Designer make her assessment of your use of our logos.

Health Application - Temporary Food - Community Groups ONLY

Form Navigation

Application for notification of a temporary food business and stallholders permit

Details of Site Manager or Person in Charge (if different from applicant) (Not Applicable)

Date of Event (Not Applicable)

Details of Proposed Food Handling (Not Applicable)

Food Stall Details (Not Applicable)

Mobile Food Business Details (Not Applicable)

Temporary Food Business Details (Not Applicable)

Attachments to be provided (Not Applicable)

Declaration (Not Applicable)

Technical Assistance

Grant Information