Thurston Strong Agriculture Business Grant Application October 13, 2020 October 13, 2020 Name of Business:*Name of Contact Person:*Email:* Telephone*Farm Website (if applicable): Physical Address:* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Business License #:*EIN or SSN:*Nature of entity:*Farm Business/FarmingFarmers MarketValue-Add Food ManufacturerFood/Farm CoopIf you are a food or agricultural cooperative, please indicate the # of employees, members or vendors you support or represent:Under 7 employees/members/vendors8-15 employees/members/vendors16-50 employees/members/vendorsIf you are a farmers market, indicate your total annual market sales in 2019:Under $500,000Between $500,000 and $2 MillionAbove $2 MillionIf you are a farm or farm business, indicate your primary crop/product/activity below (check all that apply):VegetablesTree fruits, tree nuts and berriesDairy productsChickens, ducks, poultry, eggsMeat productionNursery, greenhouse, floriculture, sodHerbs (including medicinal products)Hay or other forageTimber/non-timber forest productsChristmas treesGrains, oilseeds, dry beans/peasHoneyValue-added food productionIf you are a farm or farm business, indicate your primary crop/product/activity below (check all that apply): Vegetables Tree fruits, tree nuts and berries Dairy products Chickens, ducks, poultry, eggs Meat production Nursery, greenhouse, floriculture, sod Herbs (including medicinal products) Hay or other forage Timber/non-timber forest products Christmas trees Grains, oilseeds, dry beans/peas Honey Value-added food production Other Other:Please briefly describe the nature and size of your operation:*If you are a value-added food manufacturer, identify the Thurston County farm/ranch that you purchase product from:Physical location:*(Select all that apply, must be physically located in Thurston County) Lacey Olympia Tumwater Other Thurston County Is this a minority-owned business?*YesNoPlease certify that your business has experienced harm as a direct result of the COVID-19 pandemic and grant funds will be used to mitigate impacts or offset costs incurred during your associated recovery efforts. Thank you!* Click here to certify To receive funds, you will be asked to submit a W-9 form. Please certify you understand this below.* Click here to certify *Please note, it may take 2-4 weeks to process grant applicationsPhoneThis field is for validation purposes and should be left unchanged.