Washington State Farmers Market Association 2010 Annual Membership Application

Please COMPLETE AND SUBMIT this Annual Membership Application ON OR BEFORE March 1, 2010, in order to have your market included in the Washington State Farmers Market Guide, printed by the WSFMA. (Note: Markets may apply and submit AFTER March 1, 2010 but WILL NOT be included in the 2010 Market Guide and are required to pay an additional $50.00 late fee).

This application is for you to use as a worksheet for entering your information online. There is a fee of $25 for submitting a hard copy only.

Please fill out a separate Application and Survey for each market that you or your organization may operate.

* Required

What is your market status? *

New Market
Returning Market

Name of Market: *

Year Started: *

Market Location: * Physical operating address of market including cross-streets.

For proper placement on the WSFMA online Market map we need the LATITUDE of your Market location * You can find the latitude and longitude here: http://www.batchgeocode.com/lookup/

For proper placement on the WSFMA online Market map we need the LONGITUDE of your Market location * You can find the latitude and longitude here: http://www.batchgeocode.com/lookup/

City your market operates in: *

County your market operates in: *

Market Phone Number: *

Market Fax Number:

Market Website:

Market Mailing Address: *

Zip Code *

What type of location do you consider your market to be located in? *

Urban (Population density greater than 2,000/sq. mi.)
Suburban (Population density 500-2,000/sq. mi.)
Rural (Population density less than 500/sq. mi.)

Hours of Operation: *

Season: * Opening and Closing Dates

Is your market primarily: *

Open air (canopies)
Under permanent shelter
Indoors

How many vendor booth spaces can you accomodate at your market site?

Market Manager Information

The information in this section will remain confidential

Name: *

Title:

Contact Phone Number: *

E-mail: *

How many years has this person managed your market:

The market manager is considered: *

Full time
Full time seasonal
Part time

The Market Manager position is: *

Paid
Volunteer
Other:

Number of other paid market staff:

Number of other volunteer market staff:

Market Organization

Please check all that apply: *

Does the market have a board of directors, committee and/or advisors? *

Number of board meetings per year:

Number of vendor meetings per year:

Market only allows vendors from: *

Own county/island
Surrounding counties
Anywhere in Washington
Washington and surrounding counties

Do you jury your farmers?

Do you make farm visits?

Do you allow artisans (crafters)?

Do you jury your artisans (crafters)?

WIC, SFMNP, EBT, EFT

Does your market accept WIC and Senior FMNP Vouchers? *

Does your market offer EBT? *

Does your market offer EFT (Credit/Debit)? *

If yes, what system do you use?

Token System
Market Dollars
Other:

Does your market currently use a wireless device?

2010 Market Insurance

Insurance Premium is $425.00 for all markets requiring insurance, The WSFMA does not provide insurance to Non-Members. In order to be eligible for insurance for the 2010 season premiums MUST BE PAID IN FULL by March 1, 2010. Insurance certificates will be issued upon full payment of your dues and insurance fee - paid in full only.

Will your market require insurance through the WSFMA? * If your market does not require insurance from the WSFMA, you will need to send us a copy of your insurance policy and the WSFMA needs to be listed as an additional insured on your insurance policy. A copy of your insurance must be on-file with the WSFMA before your opening date.

If yes, please list co-insured information: Include name, address, and phone number for all co-insured.

If no how will your market be insured?

Sponsors insurance covers market
Other:

Does your market offer a holiday event? If yes, please list the date and location.

Market Gross Sales Information

Please refer to the “Roots Guidelines” to submit vendor sales according to vendor categories. Please round to the nearest dollar.

2009 Gross Farmer Sales: *

2009 Gross Processors Sales:

2009 Gross Prepared Foods Sales:

2009 Gross Crafter Sales:

2009 Gross Reseller Sales:

2009 Gross Miscellaneous Sales:

What were the combined gross sales of all vendors at your Market for 2009? *

What was the average number of farmers who attended each day in 2009?

What was the total number of vendors who sold at your market in 2009? *

Please explain how your market charges vendors: * i.e. application fee, membership fee, daily stall fee, % of sales, other

Has your market ever conducted a RMA? * Rapid Market Assessment

Does your market conduct customer counts?

If yes, what is your average attendance per market day?

Membership Dues

Membership dues are based on a sliding scale from total GROSS SALES of Markets' 2009 season. Organizations with multiple markets will pay dues individually for each market.

Other Application Items

Note: if submitting your Membership Application electronically, applications will not be accepted until your payment has been received in full. Upon acceptance of membership, you will receive a letter of Membership Confirmation along with a copy of your Insurance Certificate, if applicable. Please print a copy of this application before submitting. Ctrl-P on a Windows computer.

How many 2010 Washington State Farmers Market Guides would your market like? 200 copies are adequate for most markets

The following information MUST be submitted to the WSFMA in order to qualify your market for Membership and Insurance The following can be submitted digitally by e-mailing to the WSFMA staff at info@wafarmersmarkets.com

A copy of the Market bylaws
A copy of market rules/regulations/policies/handbook
Copy of the Market vendor application(s)
I copy of the Market vendor roster listed by the categories defined in the "Roots Guidelines"

We have reviewed the following with our Market Manager/Board/Committee/Volunteers:

Washington State Farmers Market Association "Roots Guidelines"

Will the contact person named above also serve as your Market's voting representative for the WSFMA? *

Washington State Farmers Market Association Contract I/We hereby certify that the Farmers Market represented on the above in a genuine outlet for Washington Grown/Produced Agriculture and hand-crafted goods, and that those who manage/direct/oversee this market fully agree to abide by all WSFMA Bylaws and "Roots Guidelines" set forth by the Washington State Farmers Market Association. We acknowledge that failure to do so could forfeit our membership and insurance coverage.

Optional- WSFMA Board Opportunities

The WSFMA board is a volunteer board; all board members serve a three (3) year term.

Would you be interested in serving on the WSFMA Board?

Yes, I am interested in serving on the WSFMA Board
No, I am not interested at this time
I am interested in serving, but require more information, please contact me directly

Each year the WSFMA holds an annual conference. Can you please tell us what venue, speakers, activity, or topic you would like to see at the conference?

Are you able to help before/during/after the conference?

Have you attended the conference in the past?