Registration Form

Complete the registration form to participate in the program. Click here to view program terms and conditions.
  • 1 Step 1: Contact Details
  • 2 Step 2: Farm Partner Details
  • 3 Step 3: Retail Locations
  • 4 Step 4: Farmed Acres

Step 1: Tell us how to get in touch with you and where to send your rewards cheque. *Required fields

Farm/Company Name
Name (As it should appear on cheque)*
Province*
Primary Phone #*
Fax
First Name*
Address*
Postal Code*
Secondary Phone #
Last Name*
City/Town*
E-mail*
TSA#