Application - General Farm Member - Certified American Grown

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General Farm Member Application

Step 1 of 7

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Certified American Grown invites you to become a Member of one of the most significant trade associations representing domestic cut flower, cut greens and potted plant farmers in the U.S. Our diverse and unified non-profit coalition of small to large flower, greens and potted plant farms spans all regions of the U.S. and represent over 50% of the domestic production. Join us in pursuit of our vision to have a healthy, sustainable and prosperous American floriculture farming community!

Please read and complete the following form to begin the process.

Any questions? Contact us at 805-617-4900 or info@americangrownflowers.org.

Farm Contact Information

Name of Farm(Required)

Decision Maker/Primary Contact Information(Required)

First Last

Job Title

Farm Main Phone(Required)

Direct Line or Mobile Number

Email(Required)

Certification results will be emailed to this address

Farm Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Physical Farm Address (if different from above)

Street Address Address Line 2 City State ZIP Code

Do you have additional growing locations (addresses) for your farm?

Yes

No

Additional Physical Location/Facilty

Street Address Address Line 2 City State ZIP Code

Additional Physical Location/Facilty

Street Address Address Line 2 City State ZIP Code

Additional Physical Location/Facilty

Street Address Address Line 2 City State ZIP Code

Additional Physical Location/Facilty

Street Address Address Line 2 City State ZIP Code

Farm Operational Information

Annual Farmgate Sales (Gross) of American Grown Cut Flowers, Cut Foliage and/or Potted Plants(Required)

This information will be kept private and confidential.

Estimated Gross Annual Farmgate Sales:

– Includes internal farm sales for events at wholesale value

– Does not include sales from nursery stock such as tubers, root stock, bulbs, etc.

– Does not include shipping, packaging or other add on cost of selling your product.

(*This information will be kept confidential and private. Only the administrative staff of Certified American Grown will be privy to this information for use in collective industry data.)

Farm Size(Required)

Micro $1 to $99,999 gross sales per year.

Small $100,000 to $249,999 gross sales per year.

Medium $250,000 to $499,999 gross sales per year.

Large $500,000 to $1,499,999 gross sales per year.

Volume $1,500,000 and up gross sales per year.

Year Farm Established(Required)

Size of Farm in acres AND/OR sq. ft of greenhouse/hoophouse/tunnels(Required)

Number of Full Time Employees(Required)

Number of Part Time or Seasonal Employees

Growing Season(s)(Required)

Year-Round

Spring

Summer

Fall

Winter

District (check all that apply)

District 1: Alaska & Hawaii

District 2: California

District 3: Northwest

District 4: Southwest & Southern Midwest

District 5: Midwest

District 6: Northeast

District 7: Southeast

Marketing & Promotion Information

Marketing/Sales Contact Information (if different than primary)

First Last

Email

Phone

Additional Farm Employees Emails to Add to Certified American Grown Newsletters and Organizational Communications

Farm Website

Social Media Information

Facebook Page

Instagram Link

Pinterest Link

Other

Permission to use content:(Required)

In an effort to share our member’s content, from time to time, the CAG marketing team will pull content from your social media feeds, website, marketing emails and/or newsletters for the purpose of marketing, membership and/or education.

Yes, the farm hereby grants CAG permission to use content from farm’s website, newsletters, marketing emails, and/or social media.

Yes, but only social media content.

No, please contact the farm before using any content.

Other

Production Information

Please mark what varieties of flowers and foliage your farm produces.

Flower Varieties the Farm Grows

Please select the flower varieties your farm grows.

My farm only grows foliage (skip to next question)

alstroemeria

amaryllis

anemones

asiatic lilies

bachelor buttons

banksia

bells of ireland

boronia

bouquets (various styles)

brassica/kale

bupleurum

callas

camelia

canterbury bells

carnations

celosia

chrysanthemums

cone flower

craspedia/billy balls

daffodils

dahlias

daucus/ammi/QAL

delphinium

dianthus

eriostemon

flowering branches

foxglove

freesia

gardenias

genista

geranium

gerbera daisies

gladiolus

green trick

gyp/baby’s breath

heather

hyacinths

hydrangeas

ilex

iris

kangaroo paws

la hybrid lilies

larkspur

leptospermum/tea tree

liatris

lilac

lilies of the valley

limonium

lisianthus

leucadendron

marigolds

matricaria

matsumoto asters

narcissus

orchids

oriental lilies

peonies

phlox

pincushions

poinsettias

poppy

privet

protea

ranunculus

rice flower

rosehips

roses

roses, spray

scabiosa

snapdragons

solidago/goldenrod

spirea

star flower

statice

stock

strawflower

succulents

sunflowers

sweet peas

tuberose

tulips

veronica

virburnum

wax flower

yarrow

zinnias

My farm grows varieties missing from this list.

Foliage Varieties the Farm Grows

Please select the foliage varieties your farm grows.

My farm doesn’t grow foliage. Complete question above.

acacia

agonis

asparagus other

asparagus plumosis

asparagus sprengeri

boxwood

cedar

Christmas greens

cotinus

curly willow

dusty miller

eucalyptus – baby

eucalyptus – other

eucalyptus – silver dollar

ferns

grasses

grevillea

hairless conebush

herbs

honey bracelet

horsetail

huck

huckleberry

ivy

leatherleaf fern

monstera

moss

myrtle

nagi

nandina

palms

pittosporum

podocarpus

rhamnus

ruscus – Israeli

ruscus – Italian

salal

sarcicicca

tree fern

vine

My farm grows varieties missing from this list.

Were you referred by a member?

Yes

No

Who referred you?

We value your imput. What motivated you to join?

Membership Payment

Note: Eighty percent of membership dues payment may be deductible as an ordinary business expense. Restrictions on deductibility are imposed as a result of association lobbying activities. We estimate that the non-deductible portion of your dues, the portion that is allocated to lobbying, is 20%. Membership dues payments and contributions to Certified American Grown, a 501(c)(6), are not tax deductible as charitable contributions.

General Farm Member Dues(Required)

Micro Farm $200

Small Farm $350

Medium Farm $600

Large Farm $900

Volume Farm (.0005 x sales)*cap of $15,000

General Membership Payment Preference(Required)

Annual payment in full by check

Annual payment in full by credit card

Please send checks by mail to Certified American Grown, P.O. Box 23151, Ventura, CA 93002.

To calculate membership payment, multiply gross annual farmgate sales by 0.0005.

Total

Credit Card

Card Details

Cardholder Name

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