Producer Interest Form

About You

First Name

Last Name

Name of farm, mill, creamery or processor:

Email address:

Phone number:

By providing a telephone number and submitting this form you are consenting to be contacted by SMS text message. Message & data rates may apply. You can reply STOP to opt-out of further messaging.

Where is your farm located?

City

State

About your Operations

What types of products do you offer?

VegetablesFruitDairyMeatGrainsValue addedOther

How would you describe your farm/production practices? (200 words or less)

Do you have any certifications? If so, what?

If you are a produce farmer, are you GAP Certified?

Not applicableYes, with up to date documentationNoGAP Certification in process

Are you able to provide a distributor price list or availability list?

YesNo

Form Approved by Tatiana Granados 12/1/17

reCAPTCHA helps prevent automated form spam.

The submit button will be disabled until you complete the CAPTCHA.

Contact Information