Ag Passport Entry Form

Please use this form to submit your entry for our 2021 Virginia Ag Passport as part of the VAC Vision 2021 Virtual Celebration.

For a preview of what this will look like, click here.

*Council staff may contact you if there are issues or questions. Staff reserves the right to not add a submission if it is not relevant. Space limited.

Tell us who you are:

Your full name

First Name Last Name

Your company, farm or organization

Your retail address (for the passport)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Your business phone number

Area Code Phone Number

Best phone number for VAC contact

Area Code Phone Number

Your business email address

Best email for VAC contact

example@example.com

Your website

Upload your logo here please

Browse Files

Provide a description about your agritourism operation. What do you offer to the public (2-5 sentences):

Operation description/ about info:

Quick offering synopsis

i.e. Local market, local food, u-pick, seasonal events

Optional coupon offering in passport:

We will contact you once your entry is entered for your approval. Please contact Sarah Jane at sarahjane@va-agribusiness.org with subject line "Ag Passport" if you have any questions. Thank you for helping us showcase Virginia's number 1 and number 3 industries!