Application for kashrus supervision

* Required fields

Name of Company	*
DBA (if any)	*
Addresss
City
State
Zip
Phone Number	*
Type of Business
Business hours:		AM to PM
Please list all partners
Who holds lease of the Corporation?
Name of Applicant	*
Home Addresss
City
State
Zip
Cell Phone Number	*
Synagogue Affiliation
Rabbi
Phone Number
New Company?
Existing Company?
Are you presently or have under kosher supervision?
Please list the names of any other food establishments that you have you ever been the owner/manager of
A $150 non-refundable application fee must be submitted with this application. A $300 setup fee will be assessed to all new establishments.
IMPORTANT: All applications must be approved by the Vaad Kashrus committee. You will be informed in writing of the committee's decision subsequent to an initial inspection of your facility by a Vaad representative. If approved, you will be asked to sign an agreement detailing the rules and regulations of our supervision. You may not display or advertise the Vaad's name or logo until you have received a countersigned agreement from our office.