Name *

First Name

Last Name

Phone *

(###)

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What products will you offer? *

Must be locally grown or artisan products

Fresh Produce

Chicken and / or Beef

Baked Goods

Eggs and / or Dairy

Jellies

Condiments

Dried Mixes

Plants (succulents, houseplants, flowers, etc)

Handcrafted Items

Other (please specify below)