Missouri Fruit and Vegetable Growers
Database Entry System

*Farm Name:
Street Address:
*City:
Postal Code:
*County:	AdairAndrewAtchisonAudrainBarryBartonBatesBentonBollingerBooneBuchananButlerCaldwellCallawayCamdenCape GirardeauCarrollCarterCassCedarCharitonChristianClarkClayClintonColeCooperCrawfordDadeDallasDaviessDeKalbDentDouglasDunklinFranklinGasconadeGentryGreeneGrundyHarrisonHenryHickoryHoltHowardHowellIronJacksonJasperJeffersonJohnsonKnoxLacledeLafayetteLawrenceLewisLincolnLinnLivingstonMaconMadisonMariesMarionMcDonaldMercerMillerMississippiMoniteauMonroeMontgomeryMorganNew MadridNewtonNodawayOregonOsageOzarkPemiscotPerryPettisPhelpsPikePlattePolkPulaskiPutnamRallsRandolphRayReynoldsRipleySalineSchuylerScotlandScottShannonShelbySt. CharlesSt. ClairSt. FrancoisSt. LouisSte.GenevieveStoddardStoneSullivanTaneyTexasVernonWarrenWashingtonWayneWebsterWorthWright
*Phone:
Second Phone:
FAX:
Web Address:	Please, include "http://" in your web address
E-Mail:

*Crops: (Either one fruit or one vegetable must be selected from the list below)
Fruits:
	Apples		Blackberries		Blueberries
	Cantaloupes		Grapes		Nectarines
	Nuts other than pecans		Other Fruit Crops		Peaches
	Peanut		Pears		Pecans
	Plums		Strawberries		Tomatoes
	Watermelons
Vegetables:
	Asparagus		Beets		Broccoli
	Cabbage		Carrots		Corn
	Cucumbers		Eggplant		Gourds
	Green Beans		Herbs		Lettuce
	Okra		Onions		Ornamental Corn
	Other Vegetables		Peas, English		Peas, Southern
	Peppers, Bell		Peppers, Hot		Peppers, Misc.
	Potato, Irish		Potato, Sweet		Pumpkin
	Radish		Spinach		Squash, Summer
	Squash, Winter		Turnips

*Method of Growing:	ConventionalCertified OrganicDeclared OrganicTransitional to Organic Certification
Organic Certifying Agency:
*Type of Marketing:
U-Pick Farmers Market Roadside Stand/On Farm Market Mail Order Food Buying Cooperative Wholesale Community Supported Agriculture
Notes:

*Select the region that you live in based on the map. Your application will be sent to the appropriate University of Missouri Extension specialist. You will be contacted by phone to complete your application. (Select Your Region)NorthwestNortheastWest CentralCentralEast CentralSouthwestSouth CentralSoutheast