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Special Event Application for Food Truck License

  1. If your registered name isn't the name you do business as, please enter here

  2. Best Means To Contact You*
  3. Background Check Release Authorization*

    The following information will be used to run a background check. By checking "I agree", you hereby authorize Intellicorp or any reporting agency as determined by the City of Rahway to conduct an investigation into my background, and to release any and all information, documentary or otherwise, to the City of Rahway. This information will be used by the City of Rahway to determine my eligibility to obtain a Special Event Food Vehicle License. 

    I acknowledge that if my application is denied based on any record or information provided in this investigation, I have a right to request a copy of the report, to challenge its accuracy, and will be given an opportunity to correct or complete that record or information.

    This digital authorization will be considered as effective and valid as an original.

  4. How long have you lived at the above address?
  5. Will you be using a vehicle(s) in the operation of the business?
  6. Have you been convicted of a crime?*
  7. Will you or your employees be running the event?*
  8. Upload a clear face photo with a plain background and please note, that your Driver's License photo IS NOT acceptable.

  9. Electronic Signature Agreement*

    YOU ARE ADVISED THAT THIS FORM AND THE INFORMATION PROVIDED THEREON IS SUBJECT TO RELEASE TO THE PUBLIC UNDER THE OPEN PUBLIC RECORDS ACT (N.J.S.A. 47:1A-1 et seq.)

    I have read and understand the requirements of this license as authorized by Ordinance O-44-21 and Ch. 311 of the Municipal Code and understand that violations of this ordinance may result in revocation of my license and/or fines not exceeding $1,000 or by imprisonment for a term not exceeding 90 days.

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  10. Leave This Blank:

  11. This field is not part of the form submission.