Farm-to-Table Vendor Certification Application
Business Information
Business Name
Owner/Contact Person
Business Address
City
State/Province
ZIP/Postal Code
Email Address
Phone Number
Farm Information
Farm Location(s)
Products Grown/Produced
Farm Size (acres/hectares)
Production Practices
Organic
Sustainable
No Pesticide
Other
If other, please describe
Certification Details
Current Certifications (if any)
Certifying Agency (if applicable)
Distribution & Sales
List Venues Where You Sell Products
Distribution Methods
Farmers Market
Retail Store
Restaurant
Direct to Consumer
Other
Agreement
I agree to abide by the farm-to-table vendor standards and provide accurate information.
Signature
Date