Farm & Farm Based Business Registration UsernameName First Last Account Email* Enter Email Confirm Email Password* Enter Password Confirm Password Business Owner InformationWhat type of business are you?*Artisan Food ProducersCaterersCommunity Supported AgricultureDistributorsFarm & Farm Based BusinessFarm StandsFarmers MarketsGrocery & RetailPick Your OwnRestaurantsSupporting OrganizationsWholesaleNameTitlePhoneEmail Business AddressStreet AddressCityZip CodeCountyAlamanceAlexanderAlleghanyAnsonAsheAveryBeaufortBertieBladenBrunswickBuncombeBurkeCabarrusCaldwellCamdenCarteretCaswellCatawbaChathamCherokeeChowanClayClevelandColumbusCravenCumberlandCurrituckDareDavidsonDavieDuplinDurhamEdgecombeForsythFranklinGastonGatesGrahamGranvilleGreeneGuilfordHalifaxHarnettHaywoodHendersonHertfordHokeHydeIredellJacksonJohnstonJonesLeeLenoirLincolnMcDowellMaconMadisonMartinMecklenburgMitchellMontgomeryMooreNashNew HanoverNorthamptonOnslowOrangePamlicoPasquotankPenderPerquimansPersonPittPolkRandolphRichmondRobesonRockinghamRowanRutherfordSampsonScotlandStanlyStokesSurrySwainTransylvaniaTyrrellUnionVanceWakeWarrenWashingtonWataugaWayneWilkesWilsonYadkinYanceyGeneral InformationBusiness Name* Website PhotoDescriptionList Your Business HoursList All Products You Grow/SellWhat farmers markets to you sell to?PracticesWhat are your production practices? Animal Welfare Approved Biodynamic Certified Naturally Grown Conventional Free Range GMO free Humanely Raised Integrated Pest Management Low Spray Organic (NOP Certified) Organic (not certified) Pasture Raised Permaculture Wild Harvested CertificationThe Piedmont Grown label is a certification mark. To protect the integrity of the label and the local food market, all businesses must meet specific standards and sign the licensee agreement. Please agree to the terms below by selecting each check box and selecting the Save or Save and Continue buttons.I attest that the below statements about my business are true, that I have read and agree to the terms in the Licensing Agreement, and that I agree to follow the stated guidelines should I choose to use the Piedmont Grown logo.*YesNoTotal product by weight—excluding sugar, water, salt, oil, and wheat—must be 75% local ingredients from certified Piedmont Grown farms.* Agree Total product by weight—including all ingredients—must be 40% local ingredients from certified Piedmont Grown farms.* Agree No single product ingredient can come from a mixture of local and non-local sources. For example, a jar of salsa cannot use a combination of Piedmont Grown tomatoes and tomatoes from a non-local source.* Agree Package 1Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name Total $0.00 This iframe contains the logic required to handle Ajax powered Gravity Forms.