Become a vendor This field is hidden when viewing the formNext Steps: Sync an Email Add-OnTo get the most out of your form, we suggest that you sync this form with an email add-on. To learn more about your email add-on options, visit the following page: (https://www.gravityforms.com/the-8-best-email-plugins-for-wordpress-in-2020). Important: Delete this tip before you publish the form.Business Name:Name(Required) First Last TitleEmail(Required) Enter Email Confirm Email Phone:Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Do any of the Following apply to your busniess: Women Owned Tribal Owned Minority Owned Veteran Owned LGBTQ Owned Socially Disadvantaged Business Core business:(Required) Distributor Processed Food and/ or Product Farmer/Rancher New Mexico Produced Product or Service:(Required) Yes No Product(s) for sale:Means of Delivery: Direct to Stores Co-Op Distribution Center Which Locations: Nob Hill Rio Grande Santa Fe Gallup Co-Op Distribution Center
