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Fourth of July Vendor Form

Vendor Form


Please enter the vendor name.

Please enter your name.

Please enter your sales tax number

Please enter your street address.

Please enter your city.

Please select your state.

Please enter your zip code.

Please enter your work phone number

Please enter your cell phone number.

Please enter your email address.

Please list in detail all food or products you will be selling along with the prices you plan to charge. All menu items are subject to review and approval by the food committee.

Please list the source of the foods you plan to sell.

Vendors are encouraged to bring their own power supply. Missouri Southern will work to assist those who need power. If you plan on bringing your own power please indicate that below. If you need power please indicate what voltage and amperage amounts that are needed below. Additional power is subject to additional fees.

Please enter the voltage required.

Please enter the amperage required.

You will be required to adhere to all health department specifications and it will be the sole responsibility of the vendor to meet these. NO WATER WILL BE PROVIDED.

Each vendor MUST PROVIDE A MINIMUM OF 1-10 LB. ABC DRY CHEMICAL FIRE EXTINGUISHER that is ready for immediate use. If you are cooking with grease, animal fat, oil or in a deep fryer then a Class “K” fire extinguisher must also be available in the immediate area of the cooking.

Please include a photo of the area in which you will be working and selling your product.

Include a Certificate of Insurance for liability insurance with application.

Please return contract and payment to:
Randon Coffey
Missouri Southern State University
3950 East Newman Road
Joplin, MO 64801

Payment should be made to “Missouri Southern State University” for the exact amount.

For any questions regarding facilities or set up please contact Missouri Southern State University by calling 417-625-3075 or emailing For questions regarding City License requirements please contact the City of Joplin Finance Department, (417) 624-0820 ext. 242.

The vendor agrees not to hold the City of Joplin, Missouri Southern State University, event sponsors or their directors, agents, employees and volunteers liable for any or all expenses, claims, actions, liabilities, damages and/or losses arising out of their participation in “Joplin’s 4th of July 2018”. I will be solely responsible for my own liability, and I have read all of the rules and correspondence of the event and agree to abide by them.

By typing your name you are signing this document electronically.

The City of Joplin and Missouri Southern State University may use photographs and videotapes of “Joplin’s 4th of July 2018” for promotional purposes, web pages, and other media usage. By means of submitting this application, you are hereby granting permission for photos or film of you/your act/your merchandise or both to be utilized for promotional purposes of “Joplin’s 4th of July 2018”. We reserve the right to obtain and release, as well as deem necessary, promotional information for the purpose of advertising, etc. Such materials shall become the property of The City of Joplin and Missouri Southern State University and may include photos, videos, and biographical data.