Beekeeper Registration

General Information

Company Name:
Street Name & Number (If applicable):
PO Box (If applicable):
City / Town:
State / Province:
Zip / Postal Code:
Phone Number:
Fax Number:
Primary Contact:
Number of Years in Business:


Average volume of production over the last 3 calendar years in:

Production Type:

Membership Status

Payment Information

Credit Card Type:
Credit Card Number:
Expiration Month:
Expiration Year:
First Name:
Last Name:

Terms and Responsibility

I certify that the information presented above is accurate to the best of my knowledge and is applicable to the conduct of the business of the company. I am a duly authorized representative of the company and declare the intent of the company to comply with the True Source Certified® Standards of sourcing and traceability for Honey. I understand and agree that membership fees paid do not convey any rights of trademark use. It is understood that all information supplied on this document is totally confidential between the undersigned and TRUE SOURCE HONEY LLC.
Your Name:
Your Title:

If you have any questions or encounter any problems in submitting your online registration, please contact: