Northwest Tennessee Local Food Guide Magazine Registration Form 2025-2026

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* 1. Contact Information

Name of Company *

Complete Name of Owner(s) *

Address

City/Town

State/Province

ZIP/Postal Code

Northwest Tennessee County

Email Address

Phone Number

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* 2. We list complete addresses, phone numbers and email addresses on the food guide; however, if you do not want specific information listed, please let us know.

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* 3. Website Page Link

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* 4. Facebook Page Link

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* 5. Other Social Media Page Link

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* 6. In 30 words or less, describe what local product(s) or services you offer:

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* 7. Please select the most appropriate category for your farm/business:

Other:

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* 8. Do you accept EBT Cards or Vouchers for payment of goods? (Select all that apply)

Yes, I accept EBT Cards.

Yes, I accept Vouchers.

I would like more information on how to do that.

No, I do not accept EBT nor Vouchers

Please read the following and select one of the choices below:

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* 9. I would like more information about advertisement sales in the upcoming Local Food Guide magazine. (all basic listings are free to publish)

Yes

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* 10. I understand that the benefits gained from being listed in the FREE NWTN Local Food Guide Magazine are a result of time, energy, and dedication from the Northwest Tennessee Local Food Network staff. I understand that any information provided in this form (except for my complete address) will be released to the public. No person will be excluded from participation in or otherwise subjected to discrimination in regard to services, programs, employment provided by the Northwest Tennessee Local Food Network based on race, sex, color, national origin, sexual orientation, disability, age, or religion.

I agree

I do not agree

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* 11. I understand the Local Food Network publishes a regional local food guide magazine, but does not offer online listings. I can register my online listing on the PickTN products website.

Yes

N/A

We greatly appreciate your efforts in helping us advance our mission: to serve as a catalyst
for a thriving and equitable local food system that is accessible to ALL. Learn more at nwtnlfn.org