Role  *

Organisation  *

Address  *

Telephone  *

Email  *

Do you serve/sell any local food at the moment?  *  Yes   No   N/A 

Please give details (eg where it is from, what proportion of your menu/sales, etc):

Any other comments? (eg what you plan to grow, what support you might need, anything else you think Harvest Brighton & Hove could do to help people grow and eat more local food):

Would you be interested in appearing on a ‘local food map’ for Brighton & Hove:  *  Yes   No   N/A 

Please tick if you would like to join the Harvest mailing list:  *  Yes   No