Value-Added Products Request Form

Please complete the form below if you would like to be added to our fresh-pack and value-added products list on our wild blueberry website.

First Name:    Last Name:

Business/Company Name:

Complete Mailing Address (include city, state, postal code, and if applicable country):

Home phone:   Work phone:   Cell phone:

E-mail:  

Website:

Are you a certified organic wild blueberry grower?Yes  No

Yes, people can "pick their own berries" on my farm?

Please list all fresh-pack and value-added products your offer:

Comments and/or additional information (please let us know if there is any nformation you would not like listed on our website):

Submit  Clear