Form Center

2. ATTENTION: This business is not approved until payment is received and vendor permit is sent out to you.
4. Business or Organization*

   Business name. If none type "New Vendor"

6. Contact Address*
8. Contact City*
9. Contact State*
10. Contact Zip*
12. Contact First Name*
13. Contact Last Name*
15. Contact E-Mail*
16. Contact Phone Number*
18. What type of vendor will you be?*

    Check all that apply.

    1. Food
    2. Merchandise
    3. Service
    4. Informational
    5. Entertainment
20. Food vendors: Please attach Lake County Health Dept. Food permit *

    Food permit https://www.lakecountyil.gov/2319/Forms-and-Applications 

22. Food vendors: Please attach Local Food and Bev tax registration*

    https://www.waukeganil.gov/323/Food-and-Beverage-Tax-Information 

24. Name of Special Event*
    Please type the name of the special event you will participating in.
26. Will you be participating one day or multiple days?*
    -- Select One --One DayMultiple Days
28. Which Day*
    Which Day
29. Which Days?*
    Which Days? Start Date

    —

    Which Days? End Date
31. Are you licensed with the City of Waukegan?*
    -- Select One --YesNo
33. Please provide Waukegan Account Number*
34. Please provide Waukegan License Number*
36. What city are you licensed in?*
38. Certificate of Good Standing
    https://apps.ilsos.gov/corporatellc/

    The State of Illinois issues certificates of good standing for organizations

40. Please attach Certificate of Good Standing from State of IL*
42. Additional notes for internal review

    Please use this space for additional notes to the internal review team

Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit

* indicates a required field