AMERICAN HOMESTEAD FOODS
PROJECT

APPLICATION

Print this Application, fill it out, and return it to the address below with your check.

Name:
Mailing Address:
City: State: Zipcode:
Shipping Address
City: State: Zipcode:
Phone: FAX:
E-mail: Website:
Farm Name: Acres in Production:
Business Name:
Hours of Operation:
Location of Your Farm:
Farmers Market Affiliation:
Location of Farmers Market or Web Site Address:
Product
Months Available
Product
Months Available
       
       
       
       
       
       
Method of Production Certified Organic: ___ Organic:___ No Chemicals: ___
Specific instructions to buyers:
 
 
Directions to your farm if difficult to locate:
 
 
I certify that the applicant represents a Family Farm* as defined by this program.
Signature: Printed Name:
Enclose check or M.O. for $30.00 and send it along with your completed application to:
American Pasturage, Inc.
P.O. Box 190
Marionville, MO 65705
(417) 258-2394