Appalachian Sustainable Agriculture Project

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Mountain Partners in Agriculture

Please fill out all *required information. All other information will be kept strictly confidential and will help us to serve the farms and farmers of our region better. Please see our privacy policy.

Contact Information
*Food Enterprise Name
*Contact Name
Title

*Street

*City

*Zip

*Phone Number E-Mail

Website

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Chef: (if applicable)

*Description
Hours of Operation

Survey
I purchase local and /or local organic food from the following sources:

Direct from area farmers:
Farms (list top three in order of sales)
Farm one
Farm Name
Contact Name
Products purchased
Farm two
Farm Name
Contact Name
Products purchased
Farm three
Farm Name
Contact Name
Products purchased

Farmers' Market(s):
please list

Local food distributors:
Distributors (list top three in order of sales)
Distributor(s) one
Name
Contact Name
Products purchased
Distributors two
Name
Contact Name
Products purchased

I feature local food in the following ways:
Last year my total purchases of locally grown food was approximately:

Mailing List
I would like to be added to the ASAP/Buy Appalachian E-mail list

I would like to be added to the ASAP/Buy Appalachian mail list

Our Privacy Policy

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©Copyright 2002 Appalachian Sustainable Agriculture Project Privacy Policy
564 Indigo Bunting Lane, Marshall, NC 28753-6430 E-mail List serve
Voice: 828-649-9452 fax: 828-649-9452 email: director@asapconnections.org
The Appalachian Sustainable Agriculture Project is an initiative of Mountain Partners in Agriculture in
partnership with Mountain Valleys Resource Conservation and Development Council, Inc.

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