2009-2010 "Fresh From Florida"
Logo Incentive Program Application
Print this page to complete the application
Bold items must be completed for processing
Entrant Name:
Title:
Company:
Store Name:
Street Address:
City:
State:
Zip Code:
Business Phone:
Tax I.D./FEID #:
Email Address:
By signing this application for incentive awards, I confirm that I have followed the guidelines and rules governing the "Fresh from Florida" Logo Incentive Program, and certify that information included within the entry is correct.
Print Name:
Signature:
Date:
Send Entries and Proof of Purpose to:
Florida Department of Agriculture and Consumer Services
"Fresh from Florida" Logo Incentive Program
Mayo Building, Room 424
407 South Calhoun Street
Tallahassee, Florida 32399-0800




