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IOWA FARM TO SCHOOL PROGRAM - 2017 PRODUCER AGREEMENT
  User and Farm Information
User Name 
Password Required Field      [Minimum 6 characters long and can have only alphabets and numbers]
Confirm Password  
First Name 
Last Name 
Street Address 
City 
State 
Zip 
County 
E-mail Address   (ex: pat@example.com)
Phone Number   (xxx-xxx-xxxx)
Fax Number   (xxx-xxx-xxxx)
Farm/Business Name 
Website  
  Farm to School Products Information
[Please select atleast one crop.]
  Crop Type Required Field Crop Name Required Field Growing Method Required Field Final Product Form Required Field Pounds Required Field
1.
Fresh
Bottled
Dried
Packaged
Frozen
Jams/Jellies
Prepared
Salsa
Sauces
Other
Baked Goods
Wine
Cider/Juice
 lbs
2.
Fresh
Bottled
Dried
Packaged
Frozen
Jams/Jellies
Prepared
Salsa
Sauces
Other
Baked Goods
Wine
Cider/Juice
 lbs
3.
Fresh
Bottled
Dried
Packaged
Frozen
Jams/Jellies
Prepared
Salsa
Sauces
Other
Baked Goods
Wine
Cider/Juice
 lbs
Add another crop Add another crop
  Please answer the following questions  
Are you able to provide clean product in new or clean bags or boxes?   Yes No
Is delivery available?   Yes No
Is on-farm cold storage available to properly store fruits/vegetables?   Yes No
Will you provide product free of significant bruising, insects and decay?   Yes No
Do you have a food safety plan in place? (such as written plan, employee training, food handling procedures) (certification not required)   Yes No
Do you have a tracking system in case an item needs to be recalled?   Yes No
School tours available?   Yes No
Interested in being a classroom speaker?   Yes No
Have you worked with a school in the past   Yes No
Any comments or additional information regarding your operation  
  Contact Us
 
By submitting this you are agreeing to being included on a directory for Food Services Directors
If you have any questions, please contact:
Tammy Stotts
Iowa Department of Agriculture and Land Stewardship
Agricultural Diversification and Market Development Bureau
502 East 9th Street
Des Moines, IA 50319

E-mail: tammy.stotts@iowaagriculture.gov
Telephone: 515-281-7657


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