Produce Safety Grant Application
Application for the FSMA matching grant
Operation Name *
Owner Name *
Email *
Address *
Phone number *
What Produce Safety Project(s) (FSMA) would you like to submit for matching funds?
What problem(s) are you hoping to resolve with this project?
How much did/will that project cost? (Expenditures must be from 1/1/2020 or later.)
Is your Farm Registered with the Department of Agriculture, Trade & Consumer Protection Produce Safety section?
Clear selection
What's your Registration Number?
Has someone at your farm taken a produce safety course equal to the FDA requirement under 21 CFR 112.22?
Clear selection
That person's name:
Have you had an On-Farm Readiness Review?
Clear selection
Was this project recommended by that Review?
Clear selection
Have you had an On-Farm Produce Safety Inspection or 3rd party audit?
Clear selection
Was this project recommended by that inspection or 3rd party audit?
Clear selection
Submit
Never submit passwords through Google Forms.
This form was created inside of Administrative.