Produce Perks New Market Application
Thank you for your interest in Produce Perks.  This form is for Market Manager or site owners only.  If you are a customer, please use the Market Locator Tool to find the closest market to you that offers the Produce Perks match: https://produceperks.org/locations/

To help us better understand your market, please answer as many of the following questions as possible.  All information provided will be kept confidential.
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Contact Name *
Email Address *
Phone Number *
Site Name *
Location Address
Mailing Address *
What year did your site become authorized to accept SNAP? (Leave blank if you do not accept SNAP at this time)
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What is your FNS number? (If applicable)
Do you use tokens or paper scrip to represent SNAP dollars at your site?
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What were your SNAP sales ($) for the previous calendar year? (If applicable)
What year did your site begin operating?
Do you currently, or have you in the past, offered an incentive program? *
If so, what year did you begin offering incentives?
Do you have current/potential funding for a matching incentive?
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Do you offer any nutrition education or onsite resources for customers?  If so, what kinds?
Is your site a: *
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