Membership application

Membership Application

In what state is your farm located?
Name of Owner(s):
Prospective Member Name(s):
Farm Name:
Years in Operation:
Mailing Address
Street 1:
Street 2:
City:
State:

Zip Code:

Farm Contact information
Email:
Phone number:
Farm’s website:
Facebook:
Twitter:
Instagram:

List the organizations to which you belong and describe any position of responsibility:
Are there any particular skills or knowledge you can share as a member?

Open to the Public regularly:

Hours open to the public:

Description of farm (products, experiences customers will have, offerings, you might also note certifications your farm holds, MEAPP, organic, Naturally Certified, etc.):
If available, please add an image file of your farm’s logo:
If available, please add up to six photos of your farm:
Second File
Third File
Fourth File
Fifth File
Sixth File