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Florida-Agriculture.com
Division of Marketing and Development
Florida Department of Agriculture and Consumer Services
Mayo Building, M-9
407 South Calhoun Street
Tallahassee, FL 32399-0800
(850) 487-8000

Florida Department of Agriculture and Consumer Services
Charles H. Bronson, Commissioner

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

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