Member Sign-Up First Name *Last NameEmail Address *Farm Info (Public)This information WILL be printed on the map & websiteFarm Name *Street Address *City *ZIP / Postal Code *Farm Phone NumberWebsite (URL)Facebook Name / HandleInstagram Name / HandleOther Social NetworksFarm/Member Description (Short) *Map space is limited. Please limit your description to 100 words or less0 / 100Farm/Member Description (Long) *This is for the website profile.0 / 100Certified OrganicIf you are certified, you must provide a copy of your certificateCertified Organic? *YesNoIf you are Certified Organic, please email your Certificate to [email protected].Private Contact InformationThis information is for us to contact you ONLY and WILL NOT be published, sold or given out to the publicFull Name *Street Address *City *ZIP / Postal Code *Phone Number *Email Address *Picked and U-Pick OfferingsPicked and U-Pick Products *Please list the products that you offer and if it is a Picked/Prepicked or U-Pick product. (one item per line)Terms and AgreementI AgreeBy completing this application I agree to participate and obligation to pay annual membership dues, before the due date, in exchange for my listing being included in the annual brochure/map and posted on HarvestForYou.com website and mobile appName Send Message
