Fresh Bucks Application and Acknowledgment for Market/Venue Outlets
By completing and signing this application I have entered into agreement to be an approved Fresh Bucks Market/Venue. Approved Market/Venues can distribute and/or accept Fresh Bucks for fresh fruits, vegetables, herbs, edible plants (including seeds) and/or provide a 50% off discount on SNAP transaction once a day per SNAP user. I have verified that the information provided is true and correct. I agree to follow all requirements as stated in the Fresh Bucks Guide. I agree to utilize any upfront funds appropriately and will return any unused funds to the Fresh Bucks Program. Additionally, I agree to tally and report as advised by the Fresh Bucks Program and send all required documents to the Fresh Bucks Program within the requested time frame. If there are any changes to this application it is my responsibility to update my Fresh Bucks application. To contact the Fresh Bucks program, email at Freshbucks@marionhealth.org or call 317.221.3527
USDA FNS # (You must be accepting SNAP prior becoming an approved Market/Venue) *
Year *
Application status *
First Name *
Last Name *
Market/Venue Street address *
City *
State *
Zip code *
County *
Market/Venue Name *
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