A Supplemental Category Form is REQUIRED for your Small-Scale Farm Grant Application to be considered.

Do you currently sell at a farmers market that accepts any of the following EBT payments? -Supplemental Nutrition Assistance Program (SNAP) -Women, Infants and Children (WIC) -Senior Vouchers (SV) — Yes — No

If so, at what market(s) do you sell your farm goods?

Do you accept EBT payments on-farm or at your farm store stand? — Yes — No

If so, which EBT payments are you registered to process? — SNAP — WIC — SV

Do you participate in any of the following programs or activities?

— Kentucky Farm to School

— Community Supported Agriculture (CSA)

— Local Food Purchase Assistance (LFPA)

— Community Farm Alliance Kentucky Double Dollars (KDD)

— Glean Kentucky

— Donation to local food pantry or shelter

— Discounts for SNAP, WIC and/or SV recipients

— Educational programs or tours for/with schools

— Other: _____