Organic Registration: Company Information

Please add or update your company information below. If you are adding a new registration and are certified or anticipating certification, use the same company name which you received or applied for certification.

* required fields

 

Company Information

*Company Name:

*Phone:

Fax:

*Primary County:

Select County Alameda Alpine Amador Butte Calaveras Colusa Contra Costa Del Norte El Dorado Fresno Glenn Humboldt Imperial Inyo Kern Kings Lake Lassen Los Angeles Madera Marin Mariposa Mendocino Merced Modoc Mono Monterey Napa Nevada Orange Placer Plumas Riverside Sacramento San Benito San Bernardino San Diego San Francisco San Joaquin San Luis Obispo San Mateo Santa Barbara Santa Clara Santa Cruz Shasta Sierra Siskiyou Solano Sonoma Stanislaus Sutter Tehama Trinity Tulare Tuolumne Ventura Yolo Yuba

Website:

Preferred method to renew registration:

OnlineMail (2-3 week processing time)

 

 

Company Mailing Address

*Address:

Address 2:

*City:

*State/ Province/ Region:

*Zip/ Postal Code:

*Country:

Select Country Other United States

 

 

Company Physical Address

Same as Mailing (No P.O.Boxes)

*Address:

Address 2:

*City:

*State/ Province/ Region:

*Zip/ Postal Code:

*Country:

Select Country Other United States

 

 

Owner Information

Prefix:

----- Mr Mrs Ms

*First:

MI:

*Last:

Suffix:

*Company Name:

Same as Company Mailing Address

Email:

*Preferred Method of Contact:

Select Phone Fax Email Mail

Is the owner of this company a U.S. Veteran?

YesNo

(DD214 Required)

Is the owner also the primary contact for this company?

YesNo