Fresh From Florida
Logo Incentive Program Application
Print this page to complete the form
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:
Web Site:
Page 2
I am seeking award dollars for:
Cartons
Number Printed:
Actual Cost:
Consumer Packages
Number Printed:
Actual Cost:
Business Vehicle (# Vehicles):
Actual Cost:
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.
Signature:
Send Entries and Proof of Purpose to:
Florida Department of Agriculture and Consumer Services
"Fresh from Florida" Logo Incentive Program
Mayo Building, Room 423
407 South Calhoun Street
Tallahassee, Florida 32399-0800
