"Membership Application & Agreement" - Kentucky

Membership Application & Agreement is a legal document that was released by the Kentucky Department of Agriculture - a government authority operating within Kentucky.

Form Details:

  • Released on December 1, 2020;
  • The latest edition currently provided by the Kentucky Department of Agriculture;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Kentucky Department of Agriculture.

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Kentucky Department of Agriculture
Kentucky Proud® Promotional Program
111 Corporate Drive | Frankfort, KY 40601
Phone: (502) 782-4129
www.kyproud.com
2021 Membership Application & Agreement
As referenced by KRS 260.030 a primary function of the Office of Agricultural Marketing is to “promote the sale of Kentucky-
grown products locally and in domestic and international markets.” The Kentucky Proud marketing program assists Kentucky
producers in marketing Kentucky grown, processed or manufactured agricultural products locally, nationally, and internationally.
Instructions: Please complete all information, including physical and mailing addresses, release statements, and business
and product information details.
Business Information
Company/Farm Name:
Contact Name:
Physical Address (No P.O. Boxes):
City:
County:
State:
Zip:
(
)
(
)
Phone:
Mobile:
Fax:
(
)
Website:
Email:
Mailing Address (If different from physical address)
Mailing Address:
City:
County:
State:
Zip:
(
)
(
)
Phone:
Mobile:
Fax:
(
)
Website:
Email:
Final Approval from Department of Agriculture (For Office Use Only)
The applicant has met the requirements of the Kentucky Proud® program and is hereby granted a license to use the Kentucky
Proud® logo as outlined by the terms and conditions included in this application.
Approver Signature & Title
Approval Date
Kentucky Proud Application
Revised 12/2020
Page 1
Kentucky Department of Agriculture
Kentucky Proud® Promotional Program
111 Corporate Drive | Frankfort, KY 40601
Phone: (502) 782-4129
www.kyproud.com
2021 Membership Application & Agreement
As referenced by KRS 260.030 a primary function of the Office of Agricultural Marketing is to “promote the sale of Kentucky-
grown products locally and in domestic and international markets.” The Kentucky Proud marketing program assists Kentucky
producers in marketing Kentucky grown, processed or manufactured agricultural products locally, nationally, and internationally.
Instructions: Please complete all information, including physical and mailing addresses, release statements, and business
and product information details.
Business Information
Company/Farm Name:
Contact Name:
Physical Address (No P.O. Boxes):
City:
County:
State:
Zip:
(
)
(
)
Phone:
Mobile:
Fax:
(
)
Website:
Email:
Mailing Address (If different from physical address)
Mailing Address:
City:
County:
State:
Zip:
(
)
(
)
Phone:
Mobile:
Fax:
(
)
Website:
Email:
Final Approval from Department of Agriculture (For Office Use Only)
The applicant has met the requirements of the Kentucky Proud® program and is hereby granted a license to use the Kentucky
Proud® logo as outlined by the terms and conditions included in this application.
Approver Signature & Title
Approval Date
Kentucky Proud Application
Revised 12/2020
Page 1
Determination of Membership Eligibility
Instructions: Please check all of the following categories below that apply to you and your products. We have provided definitions
to assist you in choosing the appropriate categories for your business and products.
Full Membership Categories
Membership in the Kentucky Proud marketing program is limited to those who produce or directly serve in a marketing capacity of
Kentucky-grown agricultural products as defined by KRS 260.016. KRS 260.016(1) “Agricultural product” means any farm product
grown, raised, or produced as a result of being in the business of “agriculture” as defined by KRS 246.010; and (2) “Kentucky-grown
agricultural product” means any agricultural product grown, raised, produced, processed, or manufactured in Kentucky.
Agritourism Venue
A working farm or any agricultural, horticultural, or agribusiness operation that is open to
the public for the purposes of enjoyment, education or active involvement in the activities
of the farm or operation.
Brewery
A brewery is any place or premise where beer, malt liquor and/or hard ciders are
manufactured for sale, and which are registered in the office of any collector of internal
revenue for the United States. Breweries engage in the business of a brewer under the
terms and conditions of KRS 243.150
Community Supported
A CSA’s focus is usually on a system of weekly delivery or pick-up of vegetables and fruit,
Agriculture Operation (CSA)
flowers, eggs, dairy products and/or meat.
Contract Packer/Co-Packer
A company that manufactures and packages foods for other companies to market and
distribute. A co-packer works under contract with the hiring company to manufacture food
as though the products were manufactured directly by the hiring company.
Cooperative
An enterprise or organization owned by and operated for the benefit of those using its
services.
Distillery
A distillery is any place or premise where distilled spirits are manufactured for sale, and
which are registered in the office of any collector of internal revenue for the United States.
It includes any United States government bonded warehouse. Distilled spirits means any
product capable of being consumed by a human being which contains alcohol in excess of
the amount permitted by KRS Chapter 242 obtained by distilling, mixed with water or other
substances in solution, except wine, hard cider, and malt beverages.
Distributor/Wholesaler
Person or firm that buys large quantity of goods from various producers or vendors,
warehouses them, and resells to retailers. Wholesalers who carry only non-competing
goods or lines are called distributors.
Farmers' Market
A prescribed location(s) where two or more producers gather on set days/times to sell
products that they grow/produce directly to consumers. Though the market may allow
other types of sales, the sale of agriculture products grown or produced by the seller or
their family should be the primary business of the market. If the location sells for other
farmers who are not present, then review the definitions of produce market/roadside
market and on-farm market. (Only select this category if you are a representative of a
farmers’ market. Do not select this category if you are only a vendor of a farmers’ market)
Food Service
The practice or business of making, transporting, and serving or dispensing prepared foods,
as in a restaurant or commissary.
Garden Center
Retailer of flowers, trees, shrubs and/or ornamental landscape products.
Greenhouse
A greenhouse is a building with glass walls and roof for the cultivation and exhibition of
plants and plant products under controlled conditions. The definition of plants and plant
products is the same for greenhouses as it is for nurseries.
Grocery
A store established primarily for the retailing of food items. This includes produce markets
and convenience stores along with the traditional grocery store.
Kentucky Proud Application
Revised 12/2020
Page 2
Hospital
An institution that provides medical, surgical, or psychiatric care and treatment for the sick
or the injured.
Manufacturer
A person, an enterprise, or an entity that manufactures something.
Nursery
A nursery is any grounds or premises on or in which nursery stock is processed and grown,
or from which nursery stock is collected for sale, or any grounds or premises on or in which
nursery stock is being fumigated, treated, packed, or stored. Nursery stock means all field
or container-grown and native trees, sod, shrubs, herbaceous perennials, vines, cuttings,
grafts, scions, buds, fruit-pits, and other seeds of fruit and ornamental trees and shrubs;
also other plants and plant products for, or capable of, propagation, excepting field,
vegetable, and flower seeds, bedding plants, bulbs, and roots. Plant and plant products
means any trees, shrubs, vines, foliage and cereal plants, and fruit, vegetables, roots, bulbs,
seeds, wood, lumber, and all other parts of plant or plant products.
On-Farm Market
An on-farm market is located on the producer’s farm and may carry its own produce and
value-added products and the products of others.
Producer Group
An organization, association, or network of producers that utilizes a common marketing
system. Example: CPH-45.
Producer/Grower/Breeder
A farm or business with active farming operations that grows, raises and/or breeds
Kentucky agricultural product(s).
Restaurant
A retail establishment that serves prepared food and drink to customers. Service is
generally for eating on premises, though the term has been used to describe take-out
establishments and food delivery services. The term covers many types of venues and a
diversity of styles of cuisine and service.
Retailer
Any retail outlet that carries Kentucky Proud items that does not fit the other categories
such as grocery, garden center, or roadside market.
Kentucky Farm Bureau
A store or stand registered with Kentucky Farm Bureau that sells primarily produce and
Certified Farm Market
locally produced value-added products. This produce may be from local farmers or from
other sources. This marketplace is different from a grocery store because it sells primarily
produce.
School
An institution for the instruction of children or people.
Winery
A winery means any place or premises in which wine is manufactured from any fruit, or
brandies are distilled as a by-product of wine of other fruit, or cordials are compounded.
Wine means the product of the normal alcoholic fermentation of the juices of fruits, with
the usual process of manufacture and normal additions, and includes champagne and
sparkling and fortified wine of an alcoholic content not to exceed twenty-four (24%) by
volume. It includes cider, hard cider, and perry cider and also includes preparations or
mixtures vended in retail containers if these preparations or mixtures contain not more
than fifteen percent (15%) of alcohol by volume. It includes ciders, perry, or sake having an
alcohol content greater than that permitted under KRS 241.010 subsection (2)(i).
Other Applicants
For those applicants that support Kentucky agriculture but do not qualify in one of above categories, who wish to promote the
Kentucky Proud® brand in their business or marketing strategies.
Supporter
Kentucky Proud Supporters are granted rights to solely use
the Kentucky Proud Supporter logo to promote and support
the goals and mission of the Kentucky Department of
Agriculture and the Kentucky Proud program.
Kentucky Proud Application
Revised 12/2020
Page 3
Farm Impact
1. Are your products or major ingredients of your products grown/raised in Kentucky? |  Yes  No  N/A
2. Are your products processed in Kentucky? |  Yes  No  N/A
3. Where are your products grown? (City, County, State) ____________________________________________________
4. Where are your products processed? (City, County, State) _________________________________________________
5. Where are your products packaged? (City, County, State) __________________________________________________
6. Do state and/or federal organizations inspect or license your product or facilities? |  Yes  No  N/A
a. If yes, are all licenses, permits, and/or inspections up-to-date? |  Yes  No
7. How did you learn about the Kentucky Proud® program? |  KDA Website |  KDA Staff |  Tradeshow |  Referral
 Other: ___________________________
8. Does your business reside in one of the following Appalachian counties? (Adair, Bath, Bell, Boyd, Breathitt, Carter, Casey,
Clark, Clay, Clinton, Cumberland, Edmonson, Elliott, Estill, Fleming, Floyd, Garrard, Green, Greenup, Harlan, Hart, Jackson,
Johnson, Knott, Knox, Laurel, Lawrence, Lee, Leslie, Letcher, Lewis, Lincoln, Madison, Magoffin, Martin, McCreary, Menifee,
Metcalfe, Monroe, Montgomery, Morgan, Nicholas, Owsley, Perry, Pike, Powell, Pulaski, Robertson, Rockcastle, Rowan,
Russell, Wayne, Whitley, Wolfe) |  Yes  No
“Kentucky Proud®” Terms and Conditions (for full members only)
The Kentucky Proud® logo may only be used by licensed, qualified applicants on agricultural products grown and/or
processed in Kentucky.
1. Product's major ingredients shall be grown and/or processed in Kentucky.
2. The farm(s) where the ingredients are grown, processing/production facilities, or corporate headquarters shall be
located in Kentucky.
3. Facilities shall meet all State and Federal regulations where applicable. Products shall meet or exceed USDA and/or
State of Kentucky standards where applicable.
4. Logo cannot deviate from its original design or color without prior written approval from the Kentucky Department
of Agriculture, Office of Agricultural Marketing. The individual colors of the Kentucky Proud® Logo - red (PMS 187),
blue (PMS 294), and green (PMS 357) - may not be changed to different individual colors. The Kentucky Proud®
Logo may be produced in the following single colors without prior permission: black, white, green (PMS 357 C), or
brown (PMS 13-16 C). Any other single color requires written permission from KDA. The Kentucky Proud® Logo in
white on any solid color is acceptable.
5. The logo shall only be used in association with approved agricultural products for which the major ingredients were
grown and/or processed in Kentucky.
6. The use of the logo is royalty free, but is personal only to the applicant. The logo shall not be reassigned to
another party. The Kentucky Proud® symbol is registered with the Kentucky Secretary of State and regulated by the
Kentucky Department of Agriculture.
7. Permission to use the logo may be denied or revoked at any time by the Kentucky Department of Agriculture, Office
of Agricultural Marketing.
8. The Kentucky Department of Agriculture is in no way liable for, nor does the Department guarantee products using
this logo.
9. Upon approval of the initial application, the Department shall provide artwork for each approved applicant.
Application to use the Kentucky Proud® logo
1. Any person, farm, or firm marketing Kentucky grown and/or processed agricultural or food products may submit an
application to use the Kentucky Proud® logo on eligible products.
2. Applicants agree to allow visits to production and/or processing facilities to verify compliance with guidelines
established by the Department.
3. Application shall be made on forms provided by the Kentucky Department of Agriculture or online at
www.kyagr.com.
4. License to use the Kentucky Proud® logo shall be granted by Kentucky Department of Agriculture, Office of
Agricultural Marketing upon approved application. Licenses shall be renewed annually.
5. Applicants shall provide a description of products, packaging and proposed marketing materials. When applicable,
a label and sample of the product in a finished packaged shall be provided. All applicants shall provide a copy of
appropriate licenses, health certifications, or records of inspection by appropriate state or federal agency when
applicable.
Kentucky Proud Application
Revised 12/2020
Page 4
The Kentucky Department of Agriculture, Office of Agricultural Marketing shall provide the following services upon
request:
1. Marketing service assistance.
2. Assistance in Retail, Food Service, and Institutional marketing.
3. Advertising, sales promotions, merchandising, public relations campaigns and special media promotions throughout
the year.
4. Logo promotional materials at-cost.
The Kentucky Department of Agriculture reserves the right to revise these guidelines. The Kentucky Department of Agriculture
does not discriminate on the basis of race, color, national origin, sex, religion, age, disability, sexual orientation, gender
identity, veteran status, or genetic information in accordance with state and federal laws. Reasonable accommodations are
provided upon request. Printed with state funds.
Release to Publicize Information
The following contact information will be used in the Kentucky Department of Agriculture’s printed and electronic marketing
materials which include the Kentucky Proud® “Company and Product Search Applications” located on the Department’s Web
site, www.kyproud.com: Company/Farm Name, Contact Name, Mailing Address, Physical Address, City, County, State, Zip
Code, Website, and Phone Number.
Indicate if you would like the following information used in printed and electronic marketing materials:
 Yes  No
Cell Phone
If yes, please provide:
(
)
-
 Yes  No
Email Address:
If yes, please provide:
By entering into the Kentucky Proud® Program, I understand that I am authorizing the Department of Agriculture to make
public my business contact and product information for use to the general public, both in printed and electronic format. If I
choose to opt out of this provision I must indicate so in writing to the Department of Agriculture.
Applicant Signature
Date Signed
Release to Publicize Information
Upon approval, I agree to release and hold harmless the Commonwealth of Kentucky, its successors and assigns, and its
directors, officers, employees, and agents from all claims, demands, damages, losses, charges and causes of action arising or
resulting from my participation in the Kentucky Proud® Program.
I have completed the application and read the Kentucky Proud® logo terms and conditions. I agree to follow these terms and
conditions when using the Kentucky Proud® logo, and I certify that my representations in this document are correct and true to
the best of my knowledge.
Applicant Signature
Date Signed
Print and mail this completed application to:
Kentucky Department of Agriculture
Office of Agricultural Marketing
Attn: Membership
111 Corporate Drive, Frankfort, KY 40601
Kentucky Proud Application
Revised 12/2020
Page 5