usa hop grower number application form - Hop Growers of America

Zip Code. County. Thank you for your interest in a USA Hop Grower Number. ... Please fill out the form in its entirety and email it to [email protected]
220KB Sizes 37 Downloads 33 Views
USA HOP GROWER NUMBER APPLICATION FORM Thank you for your interest in a USA Hop Grower Number. This is a free service provided to commercial US hop growers (minimum of 0.25 acres in production with commercial intent). Having a grower number does not require or result in membership to Hop Growers of America. If membership is desired, please visit usahops.org and submit an application. Please fill out the form in its entirety and email it to [email protected] An incomplete form will not be processed and will not receive a response. All boxes in bold are required. Successfully completed forms that meet requirements listed below will receive a confirmation email and an assigned grower number. I attest that I qualify for a USA Hop Grower Number as I have a minimum of 0.25 acres of hops in production which is intended for commercial use. Total Acreage *hop acreage only, not total farm size

Farm Name

Farm Owner First Name/Last Name

Secondary Contact First Name/Last Name

Address Line 1

Address Line 2

City

State

County

Primary Phone Number

Secondary Phone Number

Zip Code

Email

I certify that I, the farm/grower named above, must provide changes in contact information to Hop Growers of America (HGA), and will notify HGA if I no longer plan to utilize and/or qualify for this grower number. I will also not alter my display certificate in any way, or share it with any person(s) with the intention to do so. E-signature:

Date: