Your Name: Address Line 1: Address Line 2: blank City: State/Province: Zip/Postal Code: Cell Phone: 000-000-0000 Your Email: OPT OUT OF REGULATION or not Select: Farm Kitchens OK or Gov. Inspected Kitchens ONLY Do not limit my offerings to commercial producers. Local Farmers are OK Offer ONLY commercial products from Health Dept. Inspected Kitchens Select: Raw Honey & Fruit products OK or Pasteurized ONLY Raw Honey & Fruit products are OK Offer ONLY Pasteurized products

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