Certified South Carolina Application

Please complete this application, sign, and date. Upon approval from the South Carolina Department of Agriculture, you will receive written authorization for use of the "Certified South Carolina" logo.

Business/Farm Name:*
Contact Person:*
Business Address:
Address:*
Example: Columbia State Farmers Market 1001 Bluff Road Columbia, SC 29201
Mailing Address (if different from above):
Address
Example: Columbia State Farmers Market 1001 Bluff Road Columbia, SC 29201
County where business is located:
Primary Phone:
Alternate Phone:
Email:
Website:
Describe how the logo will be used by your firm:
Additional description of your business or products or relevant information potential buyers/customers should know
* indicates required fields.
Page 1 of 6