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Individual Market and Market Operator Information
Online Fill-in and Submission Form
Check One:    
Confirm Present Listing Update Listing Add New Listing
Date:  
Name of Person Submitting Form:  
Market Certificate Number:  
Market County:  
Market City:  
Market Name:  
Actual Market Site Address or intersection of Market including zip code:
(For internet map purposes):
Location Description:
Day of the Week:  
Operating Hours:  
Operating Season (month start/end):  
Name of Market Operator:  
Operator is: (Check One)    
Certified Producer Producer Association
Non-Profit Organization Government Entity
Market Contact Person:  
Market Phone:  
Market Mailing Address:  
Mailing City and Zip Code:  
Website Address:  
E-mail Address:
 
Comments: (describe any specific changes or additions)

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