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2. Applicant
4. Business Owner Name*
5. License Status*
   -- Select One --RenewalNew
7. Business Name*
8. Trade Name *
10. Mailing Address*
12. City*
13. State*
14. Zip *
16. Business Location Address*
18. Please select an option to receive your License:*
    -- Select One --In PersonEmailUSPS
22. Additional Information
24. Email Address*
25. Contact Phone*
27. Federal ID or Social Security*
    -- Select One --Federal IDSocial Security Number
28. Enter number*
30. Norfolk City Code - License Requirements, Sec. 24-25.3, 10 and Sec. 42-39
32. Description of Business Activity*
    -- Select One --Non-Food Vendor - Merchandise/Service - $50 - 999100-01Non-Food Vendor - Games, Rides, etc. - $50 - 999100-01 (10% admission tax required)Food / Beverage Vendor - Sold prepackaged - $50 - 999101-01 (Food & Beverage factory sealed)Food / Beverage Vendor - Prepared Foods/Beverages - $50 - 999101-01 (6.5% Meals Tax required)Itinerant Merchant or Show Performer - $500 - 999300-01Scope Promoter - Call for details - 999300-02 (Umbrella business license, Norfolk Scope Facility only)
34. Work performed/Service provided*
36. Event Name:*
37. Event Date:*
39. Organizer Name:
40. Contact Phone Number:
42. Event Location:
44. Event Date
46. Have you been approved by the sponsor of the listed event?
47. Answer: Yes/No
    -- Select One --YesNo
51. This information is true and correct to the best of my knowledge.
52. Acknowledgement*

    1. By checking this box you understand this statement.
54. Name:*
55. Title:*
56. Date:*
Leave This Blank:


58. 1. Receive an email copy of this form.
59. Email address

    This field is not part of the form submission.

60. Submit Submit and Print

* indicates a required field