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Hukilau Marketplace Tenant Application
Personal Information
Full Name
*
Date
*
Month
/
Day
/
Year
Street address
*
Apt/ Suite
City
*
State/Region
*
Zip Code
*
Email
*
Mobile phone number
*
Eligibility
Are you legally eligible to work in U.S. (Cloned)
*
YES
NO
Have you ever operated a business here at PCC?
*
YES
NO
Have you ever been convicted of a felony?
*
YES
NO
Business Information
What is the name of your business?
*
Attach Logo /brand /name
*
What are your menu & signature items/pricing?
*
Attach all the pictures of Menu
Do you have a blueprint of the truck? (Please attach)
*
Yes
No
Permits / Insurance
Provide License Number
*
Do you have Department of Health Food Establishment Permit?
*
Yes
No
Do you have Hawaii Fire Department approved (range hood/ re suppression) to be utilized as food establishment
*
Yes
No
Who is the installer/sub contractor for truck?
*
Address
Phone
Email
Does Truck have Insurance?
*
Yes
No
Company name
Phone number
Business Manager
Phone
Email
Food Handlers Permit
Yes
No
Serve Safe Permit
Yes
No
Attach Business Plans
Professional Business References
Please give us information about previous or current Business references
*
Note: Include Names, Company, RelationShip, Title, Contact Info.
Please give us information about previous or current Business references.
*
Please give us information about previous or current Business references.
*
Military Service
Are you a veteran?
*
Yes
No
From
Month
/
Day
/
Year
To
Month
/
Day
/
Year
Background Check Consent
If asked, Are you willing to consent to Background Check?
*
Yes
No
Signature
*
Date
*
Month
/
Day
/
Year
Submit