RVL Submission Survey

Farm or Business Name?

Contact Person

Address

City

State/Zip Code

Phone Number

County

Do you wish to have your address included in the directory?
Yes
No

Would you like to be listed in the New River Valley Directory?
Yes
No

Do you wish to have your Farm/Business located on a Locavore map ( If so, please make sure you provide a physical address in the address section?)
Yes
No

Months of Operation

Hours of Operation

What is your business's website?  (  Not facebook or twitter, enter that a little further down.)

Contact or Business email?

Social Media ( This is where you can list your facebook or twitter link, or any other media you use.)

You can choose more than one, but it will only be listed once in the paper directory. You can list a priority, or other categories in "Other".
PYO
Farm Market
Meat
Grocery
Retail
Eggs
Vegetables
Dairy
Restaurant
Flowers/Honey
Cooperative
Beverages
Community Supported Agriculture
Buyer/Club Owner

Agricultural Practices You can choose more than one list something else in "Other"
Animal Welfare Approved
Certified Organic
Grown without pesticides
Antibiotic free
Grass Fed

Business Description  

Do you wish to be a sponsor?
Yes
No