*1.To register for this program, please provide the following information. (Required.)

Name

Email Address

Street Address

City, AZ

Zip Code

Phone Number

*2.Would you like to receive emails from ADHS including information on food and product recalls, program information and healthy recipes.(Required.)

Yes

No

*3.Do you have a food handler card (if required in your county)?(Required.)

Yes

No

Not Applicable in My County

*4.What type of home baked food or confectionary item do you plan to make for sale?(Required.)