Farmer Meets Foodie: Producer Registration

Username (min 4 chars) :

Important Note: The username will be used for your shop's url. Do not use spaces or email addresses.

Password (min 6 chars)* :

Confirm:

Password Strength:

Email Address*:

Confirm Email Address:

Producer Type*:

Email format:

First Name*:

Last Name*:

Company Name*:

Address Line 1*:

Address Line 2:

City*:

ZIP / Postal Code*:

Country*:

State / Province*:

Phone Number*:

Mobile Number:

Paypal Payment Email*:

I agree with the Terms and Conditions