FBA Membership Level D: Industry (non-processor)

Are you applying for a new membership? (optional) Yes, this is a new membership application.No, I am renewing my membership.

Please choose your company/team (optional) NOT APPLICABLE3F Waste Recovery722625 NB LteeAAFCAbilexAcadian Sturgeon and CaviarADMAKSO Marine Biotech Inc.Alan ArchibaldAliment SolutionsALIVE KombuchaB.M.C. SEAFOODS LIMITEDBelly's Hot SauceBig Cove Foods Inc.Canada's Smartest KitchenCornel CeapaCovered Bridge ChipsCrosby MolassesFancy Pokket CorporationField to Fork AgriSystems ConsultingFluffy Little CowboysFresh Start FauxmageG.E. BarbourGalapo Inc.Gidney Fisheries LtdGood Robot Brewing Co.Goulding's Wholesale Ltd/ Chatman's BakeryGreat Little HarbourGreen Seafoods LtdHaskap Highland Orchards Ltd.Healthy Berries LtdInnovation PEIJava Blend CoffeeKETO NEWFSKonstantin BetmanLes Industries Corriveau IncLibramen Naturals Inc.Lobster Made EashLucky Bee Homestead Inc.M & M Farming Company Ltd.MadQMalouf Import/Export LimitedMaritime Paper ProductsMaster Indian SpiceMav Synergetic Corp.Milksta Moms IncMiller Quality SolutionsMuwin Estate Wines Ltd.Newville Foods Inc.Nicodan Logistic ServicesNova Scotia Department of AgricultureNova Scotia Department of Fisheries and Aquaculture, Agriculture (11753)Patrick GriffinPCX Advisors Ltd.Pêcheries Belle Île Fisheries Ltd.Pump House Brewery LtdPurity FactoriesRasymond ORoyal Gastronome chocolate and delicatessenRoyal Star Foods Ltd.Rudy’s Transportation Services IncSai Krishna Foods Services CorporationSankara | Online Multicultural MarketplaceSeaside Grazing Co.Shivani's Kitchen LTDSmall INdulgence PreservesSober Island Brewing CompanySouth Ridge MapleSpringbrook Cranberry IncThe Handpie CompanyThe Oat Company, Inc.The Varanda NetworkTuck's Bee Better FarmWestmorland Fisheries

Company/Team name (If not listed above) (optional)

Your Goverment Business Number *Since we receive funding from ACOA they have asked this to be required information

Your Title/Department * Business Leader Finance Food Safety HR Manufacturing Marketing Purchasing Sales Admin Click all that apply

Other Title/Department (optional)If not listed above, please add here

Province * AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundlandNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon

Business Phone *Example 506-555-1212

Address 1 *

Address 2 (optional)

City *

Postal Code *

Website Address (optional)

Facebook Address (optional)

Twitter handle (optional)

LinkedIn Address (optional)

Comments (optional)

What is your line of business * Food Processor Seafood Processor Beverage Processor Consultant Supplier Distributor Agency/Education Co-Packer Ingredients Provider Association Check all that apply

Language Preferred (optional) English French

What are you a processor of? (optional) Food = Aliments Seafood = Produits de la mer Beverage = Boissons

Food Processor of (optional) Meat Dairy Bakery Vegetables Fruit Confectionary Spices Snacks Dairy free products Check all that apply

Seafood Processor of (optional) Seafood Aquaculture

Beverage Processor of (optional) Wine Spirits Juice Water Tea Coffee Beer Non-Alcoholic Beer Kombucha Check all that apply

Do you have a retail location? (optional) Yes No

Do you sell online? (optional) Yes No

Shipping Methods (optional) Transport (road) Air Rail Ocean Courier Canada Post Check all that applies

Canadian Shipping to (optional) Atlantic Canada Eastern Canada National

Exporting to (optional) US Asia Europe Mexico Caribbean Check all that applies

What other countries do you ship to? (optional)

Is your company a subsidiary of a larger organization? (optional) Yes No

If so, what is the name of your parent-company? (optional)

Does your company have subsidiary companies? (optional) Yes No

If so, what are the names of the subsidiary companies? (optional)

In order to negotiate better pricing, what services do you use? (optional) Printing Marketing Graphic Design Border Brokerage HR / Benefits Consulting Car Rental Office Supplies (including equipment) HR/Benefits Consulting Translation

How many days per year does a company representative travel over night? (optional) 1-5 6-10 11-20 21-50 51+

As a Consultant, what is your area of expertise? (optional) Marketing / Brand Development Packaging and/or Labeling Export Readiness B2B Matchmaking Food Safety and Certifications Automation / Process Improvement Human Resources Market penetration Financial services Grant writing Food science Distribution and supply chain Product Development Preventative Maintenance Pick all that apply

Consultant "other" please explain (optional)

Do you have any food restrictions? * Yes No

What are your food restrictions? (optional)

Are you the main contact for this membership? * Yes No

If you are not the main contact, please put the main contacts name below. (optional)