Michigan Farmer Veteran Product Guide Registration
RequiredRequired Question(s)
Product Guide Registration:
Thank you for your participation in Michigan's first ever guide to veteran produced agricultural products. Provide all personal information, military information, and farm/ product information requested within the application. All materials and information submitted are subject to use within the Product Guide and by submitting this form you give your full consent to the use of this information and materials supplied to Michigan Food and Farming Systems. Please ensure all contact information, including website and email, is up to date as this will be the information used in the Product Guide and will be the primary method buyers and consumers will use to connect with you. 
 
Program Requirements:
- Honorable discharge from a US armed service.
- Michigan resident with a farm business licensed to operate in the State of Michigan.
 
Michigan Farm Veteran Product Guide Program Contact:
Adam Ingrao
Vets in Ag Network
VIA@miffs.org
951-237-5311
 
Personal Information
 
Required 1.
Please enter the information indicated below.

First Name:
Last Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

Required 2.
Sex:
Male
Female
Required 3.

Age:

25 or younger
26-35
36-45
46-55
56-65
65 or older
Required 4.

Race/ethnicity:

American Indian/Alaska Native
Asian American
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
Caucasian or White
Multiracial (two or more races)
Decline to state
Military Information
 
Required 5.

What was your military entry date? (mm/yyyy)

 

50 characters left.
Required 6.

What was discharge date? (mm/yyyy)

 

50 characters left.
Required 7.
What branch did you serve in?
Air Force
Army
Coast Guard
Marines
Navy
Required 8.
What is you current military status?
Active Duty
Retired
Separated (discharged)
Required 9.
Are you a combat veteran? 
Yes (go to 10)
No (go to 12)
10.
What conflict did you deploy? (Check all that apply)
OEF
OIF
Gulf War
Vietnam
Korea
Other  
11.
Number of deployments?
 

50 characters left.
Required 12.

Are you a service connected disabled veteran?

Yes (go to 13)
No (go to 14)
13.

What is your current VA disability rating?

 

50 characters left.
Required 14.

Describe your experiences serving in the military. (1000 characters or less)

 

1000 characters left.
Farm Business Information
 
Required 15.

How many years have you been operating your farm business?

under 5 years
5-10 years
11-15 years
16-20 years
20 years or more
Required 16.
How many acres do you farm?
10 acres or less
11-20 acres
21-50 acres
51-100 acres
100-500 acres
501-1000 acres
More than 1000 acres
Required 17.
Do you have a business plan?
Yes
No
Required 18.

What is the name of your farm business?

 

50 characters left.
Required 19.

List the contact information you want the public to use to view your products and contact you about purchasing? (e.g. website address, Facebook page address, email, phone, etc.)

 

1000 characters left.
Required 20.

What is your farm's gross sales from 2015?

 

50 characters left.
Required 21.

Describe your farm business? (1000 characters or less)

 

1000 characters left.
Required 22.

What do you currently grow/raise?

Livestock
Fruits/Berries/Nuts
Vegetables
Row Crops
Bees
Aquaponics
Flowers
Lumber
Value Added Products
Required 23.

What exactly do you grow/sell? (List of products we will list in the Product Guide)

 

1000 characters left.
Required 24.

Where do you sell your products currently? (250 characters or less)

 

350 characters left.
Required 25.

Do you own or lease your farmland?

Own
Lease
Own and lease
Required 26.

Is your farm currently certified organic?

Yes (go to 27)
No (go to 28)
27.

Who is your organic certifier? When were you originally certified and when does your current certification expire?

 

1000 characters left.
Required 28.
Has your farm been verified by the Michigan Agriculture and Environmental Assurance Program (MAEAP)?
Yes (go to 29)
No (go to 30)
29.

Mark the categories your farm has been MAEAP verified.

Farmstead Systems
Cropping System
Livestock System
Forest, Wetlands & Habitat System
Required 30.

Is your farm Homegrown By Heroes certified through the Farmer Veteran Coalition?

Yes
No
Required 31.

Thank you for registering to be included in the 2017-2018 Michigan Food and Farming Systems' MI Farmer Veterans Product Guide. Type your full name below to acknowledge your agreement to the terms listed in the Product Guide Registration section of this application. To complete the registration process please submit a few high resolution photos of you and/or your family on the farm, your products, and/or your farm to be used in the Product Guide to via@miffs.org.

 

50 characters left.