Agricultural Export Interest Form
Please fill out all fields below.
Company Profile:
Company Name
*
Business Address
*
Street Address
Mailing Address *if different than street address*
City
State / Province
Postal / Zip Code
Mailing Address (If different than business address.)
Mailing Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County
*
Telephone
*
Format: (000) 000-0000.
Email
*
example@example.com
Website
Back
Next
Export Information:
Is/has your company enrolled or been enrolled in a Food Export Association Program?
*
YES
NO
If so, which?
Sales Area (Where product is currently sold, select all that apply.)
*
Local
Regional
International
Ohio Only
National
Product(s) you are looking to export?
*
Market Segment (How product is currently sold, select all that apply.)
*
Bulk
Certified Organic
Consumer Direct
Convenience Foods
Distributor
Ethnic
Feed Ingredients
Food Service
Fresh
Hallal
Health Foods
Ingredients
Kosher
Livestock Genetics
Non-GMO
Private Label
Retail
Specialty / Gourmet
Wholesale
Wood
Business Type (Current description of business, check all that apply.)
*
Agent
Broker
Co-packer
Consultant
Cooperative
Distributor
Elevator / Storage / Warehouse
Export Manager / Trading Company
Female Owned
Manufacturer
Minority Owned
Processor
Producer / Owner
Please provide a complete detailed narrative of your products including brand and product category if applicable.
*
*i.e. Joe's brand chocolate fudge, Mrs. X's brand cinnamon, raspberry, and chunky varieties of applesauce (available in single-serve, 8 oz. & 16 oz. sizes.)*
Please upload your companies most recent logo here:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Would you like to have your export information featured in our directory?
*
Yes
No
Back
Next
Contact Information
Please include all contacts you would like listed for your company.
Contact 1:
*
First Name
Last Name
Title
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
This contact is:
*
International
Domestic
Both
Contact 2:
First Name
Last Name
Title
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
This contact is:
International
Domestic
Both
Contact 3:
First Name
Last Name
Title
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
This contact is:
International
Domestic
Both
Back
Next
Signature
I certify that to the best of my knowledge the information on this form is true and correct.
Please Type Your Name Here
*
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: