Please provide your business information as you would like it to appear in the Source Book.

Transcription

1 Vendor Application Thank you for your interest in becoming part of the Alaska Grown Online Source Book! Please complete the following application with information about your farm as you would like it listed in the book. Applications are now accepted and updated throughout the year By submitting this application, you are giving the Division of Agriculture permission to publish your information in the Alaska Grown Online Source Book. The Division of Agriculture reserves the right to remove your listing from the Alaska Grown Source Book for good cause. Questions about the application, Source Book, or any other inquiries can be directed to or Complete the form online then click the address at the end of the application to submit your form online. You may also print, then mail or fax your application to the information provided at the end of the application. Business Details (please print legibly) Please provide your business information as you would like it to appear in the Source Book. 1. Business Contact Information Business Name: Main Contact Name: Phone Number: Physical Address: City/Town: State: ZIP: Address: 2. Are you currently an Alaska Grown member? Yes No 3. Mailing address (if different from your physical address) Source Book Mailing Address: City/Town: State: ZIP: 4. If you have a website, Facebook, or other social media account, please list the URL(s): 5. If there are any special directions to get to your farm or selling location, please write them below. 1 of 6

2 6. Forms of Payment Accepted Cash Check Credit Card SFMNP (Senior Farmers Nutrition Program) SNAP/ Quest (Supplemental Nutrition Assistance Program) WIC/ FMNP (Women-Infant-Children/ Farmers Nutrition Program) 7. Additional Business Information Alaska Grown Member Certified Organic with USDA Organic Label Willing to Host Farm Tours Intends to have Certified Weed Free products in 2016/2017 Wholesale Rates Available (For Schools/Senior Facilities/Hospitals/Etc.) Will Ship to Bush (Please specify if restricted to certain areas below) Year Round Availability (Please specify products available below) Please list additional information, certifications, and/or analyses as you would like them listed below (optional) ing Details 8. Where do you sell your product(s)? Mark all that apply. Interior Southwest Southcentral Kenai Peninsula Southeast Farm Stand Direct from Farm By Appointment Only Direct to Restaurants CSA (Community Supported Agriculture) Direct to Institutions (Senior facilities, Universities, Prisons, Hospitals, etc.) Grocery Stores Direct to Distributors Direct to Schools U-Pick (Customers pick their own product out of your fields, only for fruits and vegetables) If part of a CSA, please list who 2 of 6

3 9. Which Farmers (s) do you sell at? Below the Farmers s are split up by region. Select all locations where your product is sold. A. Interior Birch Hill Ester Park Highway s End Farmers (Delta Junction) Festival Fairbanks Nenana Farmers Tanana Valley Farmers The Southside Community Farmers B. Southwest Bethel Farm Stand Kodiak Farmers Warehouse Mountain Farm Stand C. Southcentral Alaska Pacific University Farmers Anchorage Downtown & Festival Anchorage Farmers (Cordova Street) Center (Anchorage) Depot Farm (Palmer) Eagle River Farmers Glennallen Wednesday D. Kenai Peninsula Kenny Lake Harvest KGB Corner (Wasilla) Muldoon Farmers Northway Mall Wednesday Palmer Friday Fling Peters Creek Farmers & Crafts Saturday Art & Farm (Sutton) Saturday Eagle River Farmers South Anchorage Farmers South Anchorage Wednesday Spenard Farmers Top Shelf Artisan (Palmer) Wasilla Farmers Willow Farmers Anchor Point Saturday Farmers & Swap Meet Central Kenai Peninsula Farmers Farmers Fresh (Kenai Peninsula Food Bank) Homer Farmers Kenai s Saturday Meadow Drive Farmers (Homer) Soldotna Wednesday E. Southeast Haines Farmers Ketchikan Farmers Skagway s Garden City The in Petersburg 3 of 6

4 Prince of Wales Farmers Sitka Farmers Wrangell Farmers Please List any other selling locations and/or farmers markets not listed above: Products Sold Throughout this section, click on all products you offer. Be specific, your customers search for specific items. If your product is not listed, you may add multiple products/items in the Other field. We will include as many products as space allows in the final printing. 10. Vegetables and Herbs Artichokes Beans Beets Bok Choy Broccoli Brussel Sprouts Cabbage Carrots Cauliflower Celery Chard Collard Greens Cucumber Garlic Green Onions Kale Kohlrabi Lettuce Microgreens Onions Parsnips Peas Peppers Potatoes Pumpkins Radishes Rhubarb Rutabaga Spinach Sprouts Squash Tomatoes Turnips Zucchini HERBS: Basil Chamomile Cilantro Dill Fennel Mint Oregano Parsley Sage 11. Fruits Apples Blueberries Cherries Currants Haskaps (Honeyberries) Lingonberries Raspberries Rose Hips Serviceberries Strawberries 12. Value Added and Specialty Items Beeswax Jams Essential Oils 4 of 6

5 Bee Pollen Birch Syrup Bread Cheese Frozen Berries Honey Jellies Milk Mushrooms Rhodiola Wine Liquor 13. Animals and Livestock Alpacas - Breeding Alpacas - Fiber Bison - Breeding Bison - Meat Bison - Hunts Chickens - Eggs Chickens - Breeding Chickens - Meat Cows - Beef, Breeding Cows - Beef, Meat Cows - Dairy, Breeding Donkeys Ducks - Eggs Ducks - Breeding Ducks - Meat 14. Shellfish Clams Geoducks Mussles Oysters 15. Hay and Grains Elk - Breeding Elk - Meat Elk - Hunts Geese - Eggs Geese - Breeding Geese - Meat Goats - Dairy, Breeding Goats - Meat, Breeding Goats - Fiber Goats - Meat Horses Llamas - Breeding Llamas - Fiber Musk Ox - Breeding Musk Ox - Qiviut Pigs - Breeding Pigs - Meat Rabbits - Breeding Rabbits - Meat Sheep - Breeding Sheep - Meat Sheep - Fiber Turkeys - Eggs Turkeys - Breeding Turkeys - Meat Yaks - Breeding Yaks - Meat Yaks - Fiber Barley Grass Hay Oat Hay Oats Straw Wheat 16. Horticultural and Garden Supplies Bedding Plants - Ornamental Bedding Plants - Vegetative Christmas Tree Flowers Fruit Trees Peat Moss Peonies Potted Plants - Annuals Potted Plants - Perennials 5 of 6

6 Compost Fertilizer Fishmeal Flower Bulbs Flower Seed Flowering Baskets Potting Soil Seed Potatoes Sod Please list any additional products not listed above: Thank you for joining the Alaska Grown Online Source Book! You may submit your application once completed by clicking on This will attach and your completed pdf. You may also mail your completed application to: Attn: Alaska Grown Source Book Division of Agriculture 1800 Glenn Highway, Suite 12 Palmer, AK OR fax to: of 6