Maine Senior FarmShare Program

New Farm Participation Request Form

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* 1. Farm Contact Information

Owner Name

Farm Name

Mailing Address

Farm Location

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Can your farm consistently offer a minimum of 5 different produce items at designated farm, farmers' market, or other site at any time for a minimum of 8 consecutive weeks?

Yes

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* 3. Will your farm offer delivery of shares to seniors? (NOT REQUIRED)

Yes

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* 4. What was the total acreage in fruit and vegetable production during 2018 for your farm?

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* 5. Do you currently accept WIC Farmers' Market Nutrition Program checks?

Yes

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* 6. Do you currently accept Supplemental Nutrition Assistance Program transactions?

Yes

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* 7. How many years of farming experience do you have?

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* 8. Does your farm currently offer a Community Supported Agriculture (CSA) program?

Yes

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* 9. How did you learn about the Maine Senior FarmShare Program?

Maine.gov website

Get Real Get Maine website

A participating farm

Newspaper

A senior citizen

Other (please specify)

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* 10. How do you currently market your produce? (Check all that apply)

Farm

Farm Stand

Farmers' Market

CSA

Other (please specify)

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* 11. Have you participated in the Maine Senior FarmShare Program in the past?

Yes

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* 12. Are you able to provide three professional references?

Yes

Thank you for your interest, the Maine Senior FarmShare will respond to your request within 5 business days.