Wild Blueberry Newsletter Request Form

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If you are a blueberry grower or connected to the blueberry industry, please complete the request form below to receive our wild blueberry newsletter and other pertinent blueberry information. PLEASE COMPLETE ALL CONTACT INFORMATION AND PROVIDE US WITH AT LEAST ONE TELEPHONE NUMBER - remember to keep us abreast of any changes to your mailing address or email address - this will ensure that you receive all current wild blueberry information in a timely manner!

Date
MM
DD
YYYY
Name*
First Last
Business or Company Name
Mailing Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Please select the "Maine" county and/or counties were your blueberry fields are located:
Select as many as apply. Please provide at least one telephone number.
Home Phone
Work Phone
Cell Phone
E-mail Address*
Seasonal address and telephone information:
Note: You must keep us abreast of all address changes including seasonal addresses, telephone, and email changes in order to remain on our mailing list. If you have a seasonal address, you must contact us with your new address before you leave Maine and when you return. Mail returned as undeliverable or temporarily away, will be removed from our mailing list.
Please provide some additional information.*
Select all that apply. If you are not a blueberry grower, please let us know your interest in our newsletter.
- I am a blueberry grower.
- I am an organic blueberry grower.
- I am organic certified.
- I sell fresh-pack blueberries.
- I am not a blueberry grower
Indicate how you would like to receive the wild blueberry newsletter
You may select only one option.
- Mail
- E-mail
Comments
Please use the box below to add additional information or comments.

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