Register/Renew Your Business

Please complete ALL information as required by Kansas Statute 32-1430-1438a, the Agritourism Promotion Act. Incomplete forms will not be accepted.

If you receive an error after submitting this form, please know that we have received your application and do not submit multiple times. If you have questions about your registration, contact the Agritourism Manager at 785-296-1847. Please contact us if you have not received your registration certificate after 30 days of submitting your form.

Business Information

Company Name:

Owner Name:

Business Start Date:

Business Address::

City:

State:

Zip:

Business Phone:

Fax:

Email:

Web Site:

Contact Information

First Name:

Last Name:

Email:

Contact Phone:

Address of Agritourism Location

Physical Address:

City:

State:

Zip:

County:

Agritourism Activities (only activities listed below will be covered by the statute)

Activity/activities, Amenities & Experiences:

Agritourism Experience (Website Listing - 150 Words or Less)

Describe the visitor experience including dates & hours of operation:

Disclosure Statement

The following information is requested by the Federal Government in order to monitor compliance with Federal Laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race, ethnicity and sex of applicants on the basis of visual observation or surname.

*This institution is an equal opportunity provider.

Ethnicity:

Race: