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Retail Establishment

Retailer Application

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Alternatively, download this PDF and email your Application.

First Name: Last Name:

Business Name:

Storefront Name:

Contact's Email Address:

What is your position?

Have you/does your store sponsor/hold health/wellness/fermenting classes to adults?

If so, please describe:

If applicable, how long have you (or the person teaching) been fermenting vegetables?

If applicable, please describe the method/system/brand that you have used to ferment:

Is there anything else you would like to tell us to help us make a decision regarding this Application?

Please enter the following code into the box provided: