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Fresh Local Produce Request Form

Fill out this form for your local grocer to request that they stock fresh, local produce, wine or other local food product (cheese, meats, eggs, deli, breads, pastries, etc.). If you have sampled a specific local product and would like to see it made available in your favorite grocery store, please indicate the name of the producer below. Please also indicate the name, address and phone number (Email if available) of your grocer so we can email them or send them your request.

Let your grocer know that they can also contact Slow Food® Madera for a complete list of local producers at

To help us advocate on your behalf - Take pride in supporting our local food producers and enjoy the excellence of our local bounty.

First Name
Last Name
Zip Code
Phone Number
Email Address
Grocer Name
Grocer Address
Grocer Phone
Grocer email/website
Type of Product Requested
Local Producer
Are you a SlowFood Madera member?
Yes No
Join Email List
Join Slow Food Madera
Comment or Question