Extra Acre Application
 
 
Application Information
 
IF RENEWING CURRENT EXTRA ACRE PPLICATION STATUS, PLEASE SELECT APPLICATION CLASSIFICATION "RENEWAL" AND ADD IN YOUR EXPIRING APPLICATION REFERENCE ID (found in your renewal email notification. EX: PS_Application_2021-04-20T 14:27:07Z). 
 
Application Classification
 
 
Expiring Application Ref Id (Provide if Renewing Application)
 
 
 
Applicant Contact Information
 
First Name*
 
 
Last Name*
 
 
 
Email*
 
 
 
 
Business Phone Number
 
 
Mobile Phone Number
 
 
 
 
Store Information
 
Store Name*
 
 
Store Phone
 
 
Store Email
 
 
Store Website
 
 
 
Physical Address
 
 
 
Street*
 
 
City*
 
 
State*
 
 
Zip*
 
 
Country*
 
 
 
 
 
 
 
Mailing Address
 
 
 
 
 
Mailing Street
 
 
Mailing City
 
 
Mailing State
 
 
Mailing Zip
 
 
Mailing Country
 
 
 
 
 
Primary Store Contact
 
Primary Contact
 
 
Primary Store Contact Email
 
 
Primary Store Contact Phone
 
 
Primary Distributor
 
 
 
 
Primary Distributor Representative
 
 
 
 
 
Store Details
 
Small Animal Sales Information
 
 
 
Linear Shelf Space Dedicated to Small Animal Category*
 
 
 
 
 
 
Do you have small animals in your store for adoption/sale?*
 
Yes
No
 
 
 
 
If yes, please indicate which animals below.
 
 
 
Chinchilla
 
Yes
No
 
 
 
 
 
 
Ferret
 
Yes
No
 
 
 
 
 
 
Gerbil
 
Yes
No
 
 
 
 
 
 
Guinea Pig
 
Yes
No
 
 
 
 
 
 
Hamster
 
Yes
No
 
 
 
 
 
 
Mice (non-feeder)
 
Yes
No
 
 
 
 
 
 
Rabbit
 
Yes
No
 
 
 
 
 
 
Rat (non-feeder)
 
Yes
No
 
 
 
 
Program Details
 
As an Oxbow Farm Preferred Store, we understand our store location (named above) is subject to sku and sales volume requirements. We understand that the Oxbow Farm Preferred Store Program can be changed or discontinued at anytime. We understand the approval of this application is valid for 12 months.*
 
 
 
 
 
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