Producer Membership Form

Due March 15, 2014

Name: ______Farm Name: ______

Address: ______City______Zip code______

County: ______Phone: ______

Email: ______Website: ______

Facebook: ______

Mark as needed:

I would like my email included in the directory.

I would like to sell to institutions.

Include my farm in the online, Buy Fresh, Buy Local interactive directory.

Send me a point of sales promotional material (BFBL stickers, posters, etc.) order form.

I am interested in being part of the 2014 Farm Crawl.

I want to be listed in the online local farm directory, ISU Market Maker. (I will send you more information if you mark that you are interested.)

I have enclosed my annual producer membership fee in the amount of $20, $50 or $100.

Please make checks payable to UNI-CEEE and return with the membership form to:

Attn: UNI Local Food Program

University of Northern Iowa

CEEE 109

Cedar Falls, IA 50614-0293

If you have any questions, call Rachel Wobeter at 319-273-7883 or email:

Membership Levels

Choose your level

Categories: Based on your membership level you are able to choose 1-3 categories for your farm to be listed under. The Directory has groups of farms listed under the following categories. Your farm may fit into several categories. Check your choice/s.

Due March 15, 2014

ÿ Fruit & Vegetables

ÿ CSA’s

ÿ Apples

ÿ Strawberries

ÿ Dairy

ÿ Meat, Poultry, Eggs

ÿ Honey

ÿ Wineries, Breweries, & Roasteries

ÿ Bakery

ÿ Roadside Stands

Due March 15, 2014

ÿ If your farm is a “U-Pick” farm, please check this box. We will identify the U-Pick Farms in the directory.

Please fill out the appropriate listings or descriptions, depending on what membership level you choose:

Product Listing (Basic Memberships)

MAX 15 WORDS ______

Product Description (Enhanced Membership & Full Membership)

MAX 40 WORDS

______

Farm Profile (Full Membership)

MAX 90 WORDS

______