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2. Name of entity/business making application*
3. First Name*
   Full Name of person making application for the entity or business
4. Middle Name*
5. Last Name*
7. Aliases
   Any aliases or other names used during the last seven (7) years
9. Mailing Address:*
10. City:*
11. State:*
12. Zip Code:*
14. Physical Address:*
15. City:*
16. State:*
17. Zip Code:*
19. Type of entity or business (select one)

    1. Sole proprietorship
    2. Partnership
    3. Non-Profit
    4. Other
20. Names of owners and/or partners*
22. Provide Bank reference including name of bank officer and telephone number*
24. List employment history of applicant for the last seven (7) years
    Include address and telephone number of employer and name of immediate supervisor
26. List the contact names and telephone numbers of three (3) business references (non-relative) who might be contacted by the Park Board
28. Describe type of business, location, products to be sold and prices
30. Do you have a State Sales Tax Number and Local Outlet Number?

    1. Yes
    2. No

    If yes, please email a copy to stewartbeach2@galvestonparkboard.org. If no, a copy MUST be provided upon execution of the Agreement
32. Do you have current Insurance Certificate on file with the Park Board?

    1. Yes
    2. No

    If no, a Certificate MUST be provided upon execution of the agreement.
34. Applicant's date of birth*
35. Applicant's Texas driver's license number*
36. Social Security number of applicant*
38. Have you or your company ever been convicted of a felony, in either state or federal court in the last seven years?

    1. Yes
    2. No
40. If your answer is yes, describe the type of conviction, date of conviction, case number and court of conviction
42. In order to process this application, a non-refundable fee must be submitted. Applications submitted without the fee of $500.00 will not be reviewed or considered by the Park Board of Trustees
    Contact Chris Saddler 409-797-5182 or Melissa Lathrop 409-797-5172
44. When your contract is approved by the Park Board of Trustees, and the total yearly contract amount is $5,000.00 or less, then you will be required to pay the entire amount on the earlier of: A.) the signing of the contract or B.) March 15 or whichever comes first. If the total yearly contract amount is $5,001.00 or greater, then the first and last month's minimum rental payment is due upon signing of the contract. Regarless of the contract amount, a certificate of insurance must be provided upon execution of the contract. Payments are non-refundable
46. By submitting this application, I hereby authorize the Park Board of Trustees of the City of Galveston ("Park Board") and/or its agents and representatives to use the above provided information to conduct any and all of the following background checks on me: state and federal criminal background; Texas Department of Public Safety/Department of Transportation background (and similar departments for other states); and a credit history check with at least one of the major credit history reporting companies. I understand that the Park Board will keep the above listed information, as well as any information obtained via criminal, driving and/or credit check[s] CONFIDENTIAL to the extent allowed by law, and will only use such information in evaluating applicant's suitability as a potential concessionaire.
48. In addition, I do hereby state that all of the information contained in this application is true and correct. I understand that if the Park Board of Trustees learns at any time, that any information that I have given to the Park Board in this application is incorrect or misleading, it will be a basis for my contract with the Park Board to be cancelled. I am on notice that false or inaccurate information given in this application will be considered grounds for terminating any contract I have or could have with the Park Board.
50. I agree with the above *

    1. Yes
    2. No
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52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit Submit and Print

* indicates a required field