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* Farm Name:

Please initial each statement that applies to you:

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* I (we) declare and affirm that the information submitted via the Certified Naturally Grown (CNG) application is correct and accurate, and that all information will be kept current, complete and up to date to reflect any changes.

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* I (we) have read and understood the appropriate CNG standards, and our practices adhere to the requirements listed therein.

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* I (we) understand that Certified Naturally Grown reserves the right to remove us from the program and deny us the use of the CNG logo and marketing materials for any reason including concerns that we don’t adhere to CNG standards, or have missing or misleading information on the application.

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* I (we) declare and affirm that I (we) will only represent products as Certified Naturally Grown when they actually meet the certification standards and come from a Certified Naturally Grown operation.

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* I (we) declare and affirm that all the substrate used to grow CNG mushrooms meets CNG standards, and does not contain heavy metals or byproducts of GMO crops.

Please select the answer that applies to your operation, and initial the statements:

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* The container/s used for pasteurization and/or sterilization...

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* The fruiting room racks...

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* The outdoor production area...

Please sign and date below:

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* Full name(s)

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* Date

Date

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* Use this space for anything you'd like share with us:

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