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2. Fees
   $15.00 per day or $150.00 per year. These fees are due when the application is submitted.
4. Name*
6. Permanent Home Address*
7. Apartment or Lot*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
15. Local Address*
16. Apartment or Room No.
18. City*
19. State*
20. Zip Code*
24. Sex*
25. Date of Birth*
    Date of Birth
26. Height
27. Weight
29. Eye Color
30. Hair Color
31. Driver's License No.*
32. Driver's License State*
36. Have you ever been convicted of any felony or any offense involving violence or threats of violence, possession or use of weapons, theft, fraud, or sexual misconduct?*

    1. Yes

    1. No
38. Details
    If you answered "yes" to the question regarding convictions, please give details. Include charges, dates, and places of convictions and whether you are currently on probation, parole, or any other form of supervision.
42. Company Address*
44. Company or DBA Name*
46. City*
47. State*
48. Zip Code*
50. 
    Phone Number*
51. How long have you been employed by this company or used this company name?*
55. Vehicle Used
57. Make
58. Model
59. Year
61. Color
62. License Plate Number
63. State
65. Company name or logo displayed on vehicle?

    1. Yes

    1. No
66. If so, what name?
70. Facility*
    If you will be operating out of any building, structure, tent, public room, office or fixed location in the city for the purpose of conducting business, exhibiting or selling goods, wares, or merchandise, or offering services, describe the facility and give its location, including street address. (If none, simply state "none".)
72. Does the use of such building, structure, tent, public room, office or fixed location comply with existing zoning and business regulations?

    1. Yes

    1. No
73. Length of time you expect to operate or do business in Bel Aire? (This permit is only good for 30 days.)
    Length of time you expect to operate or do business in Bel Aire? (This permit is only good for 30 days.) Start Date

    —

    Length of time you expect to operate or do business in Bel Aire? (This permit is only good for 30 days.) End Date
75. Days of Operation*
76. Hours of Operation*
    Hours of Operation Start Time

    —

    Hours of Operation End Time
80. I the undersigned applicant agree to the following provisions. My electronic signature of this form indicates that I have read and agreed to all of them.
    l. I understand and agree that if a permit is granted, it will not be used or represented in any way as an endorsement by the City of Bel Aire or by any department or officer of the city.
    
    2. I have not been convicted of violation of any law or ordinance regulating selling, soliciting or peddling within the past five years.
    
    3. I have never had a vendor or solicitation permit or registration revoked or suspended under the ordinances of the city of Bel Aire or any other city.
    
    4. I understand that it is unlawful to sell, solicit or peddle prior to 9 a.m. or after 8 p.m. on any day of the week.
    
    5. I understand that it is unlawful to ring a bell, knock on a door or otherwise attempt to gain admittance for the purpose of selling, soliciting or peddling at a residence or selling at which a sign bearing the words "No Solicitors" or "No Trespassers" or similar words are affixed or exposed to public view.
    
    6. I understand that is unlawful to engage in selling, soliciting or peddling on any premises or dwelling after having been asked to leave the premises of dwelling.
    
    7. I understand that it is unlawful to sell or solicit or peddle without carrying a valid permit and exhibiting it upon request of any resident or officer of the City of Bel Aire.
    
    I certify, under penalty of perjury, that all of the information contained in these applications is true and correct to the best of my knowledge and belief.
82. Electronic Signature*
83. Date*
    Date
87. Payment Received
89. Clerk
90. Date
    Date
91. Amount
Leave This Blank:


93. 1. Receive an email copy of this form.
94. Email address

    This field is not part of the form submission.

95. Submit

* indicates a required field