Participation Form
Farm (Business) Name:

Contact Person (Name):

Farm (Business) Address:

City:

State:

Zip:

Phone:

Fax:

E-mail:

Web site:

County/City:

Mailing Address (If different from physical address):

Directions To Your Business (Please be specific using road names and numbers):

Are you Open to the Public:
Yes No By Appointment Only
If Yes Hours and Season of Operation
Months Open in the Year:

Days of the Week Open:

Hours:

Business Types: (Check as many as apply)
Pick Your Own
Farmer's Market
On-Farm Stand
Community Supported Agriculture (CSA)
Mail Order
Aquaculture

Agritourism

Corn Maze
Farm Animals
Birthday Parties
Festivals

Fiber (Alpaca, Sheep)
Livestock (Beef, Poultry, Lamb)
Garden Center/Horticulture
Winery/Vineyard
Certified Organic
Wholesale
Processor

Farm Tours
Restaurant
Other (Please Explain):

Business Description and Products Available (Please limit your description to 4 to 5 sentences):

Special Events and Activies: (Harvest Festivals, Wine or Food Festival, etc.)
Name of Activity:

Additional Comments:

or