Preliminary Information

What is the name of this farmers market?

Farmers market name:

Market location (main site):

Street name and number (e.g., 999 USDA
Road):

City:

State:

5-digit Zip code (required):

County:

Mailing address (if different from above):

Street name and number or P.O. Box
number:

City:

State:

Zip code:

What is your relationship to this farmers
market?

Market manager
Market contact
person
Extension agent
Other, please
specify:

Contact information of the person
completing the survey:

Name of the person:

Telephone number (including area
code):

Facsimile number (including area
code):

E-mail address:

Web site of this farmers
market:

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© 2009 USDA Marketing Services Division OMB 0581-0169