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Supporting Member Grocer Application
Email address *
Business Name (or DBA) *
Business Name (as registered with IRS) *
Business Logo: *
Required
Business Description: *
(75 Word Limit)
Business Address(es): *
Please be sure and include City, State and Zip Code
Mailing Address: *
Please be sure and include City, State and Zip Code
Contact Name: *
Business Phone: *
Hours: *
Website: *
Social Media Profiles:
Commitment to sourcing local products: *
This is where you get to showcase your business's commitment to sourcing local and enhancing our local food economy. Please finish the following sentence: (Your Business Name) is committed to sourcing local because... Example: WFFC is committed to sourcing local because when we spend our food dollars locally, everyone benefits! (25 Word Limit)
Percentage of local food products: *
_________% of our total food products offered come from farms, ranches and fishermen within 100 miles. (If you don’t know the % your of total food products please specify by categories.) Example: 40% of our meat come from farms within 100 miles.
Percentage of local processed food products: *
_________% of our total processed food products offered come from Willamette Valley businesses (e.g., Springfield Creamery, Surata Tofu, SweetCreek Foods, Coconut Bliss, etc.)
Sustainability Highlights:
Please list highlights of your business practices in all categories that are appropriate.
Please Provide More Details About Your Sustainability Highlights above:
What locally grown and crafted products do you sell: *
Required
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