First Name:

Last Name:

Organization (if applicable):

E-mail:

Phone:

Bee Friendly "Farm" Physical Location:

Address:

City:

State:

Zip:

Mailing Address, if Different from the Above:

Address:

Address2:

City:

State:

Zip:

1. I am a Beekeeper--

Beekeeper
Hobbyist
Sideliner
Commercial beekeeper or manage solitary bees (mason, alkali, leafcutter)
I have a year-round apiary on my land
I provide access to a beekeeper to pasture his or her bees
I plant or manage lands for bees (examples-as a naturalist, restorationist, wildlife habitat manager or botanist)

If you are a Beekeeper, You are done! to complete your bee friendly certification and pay the $25 annual certification fee.

2. Type of bee friendly farm operation or wildlife or native habitat you are certifying (check all that apply)

Orchard
Vineyard
Vegetable operation
Fruit operation, bee pollinated (berries, melons, etc.)
Seed crops, bee pollinated
Farm
Ranch
Landscaping management on my property
Land planted, managed or restored for bees
Other

3. How do you currently provide forage for bees? Honey bees and native bees require a succession of flowering plants throughout the season, in particular late summer-fall. Check all that apply (minimum 2)

Bee-attractive flowering perennials
Berries
Ground covers/cover crops (e.g., clovers, mustard, vetch)
Restored native meadows, pollinator friendly wildlife plantings
Bee-attractive flowering fallow crops
Flowering hedgerows
Flowering trees that provide nectar/pollen
Insectary garden (flowering plants grown to attract beneficial insects)
"Weedy" areas not managed (allowed to flower)
Other

4. Please provide the plant names (common names are fine) on your property that provide pollen and nectar during each season. Click Here to see which plants are currently listed in the California NRCS Pollinator Biology Tech notes (minimum of 2 plant varieties per season--10 plants total--required from Pollinator Tech notes plant list).  If you are not located in California, consult your State NRCS office for information about pollinator-beneficial plants in your state. 

5. Size of your operation (acres)

6. What percentage of your operation contains bee forage? (Minimum of 6 percent of your acreage, including natural areas on your property adjacent to cropland, to qualify for certification)

7. Describe how you provide nesting for bees. Check all that apply (Minimum requirement: 2)

Undisturbed (untilled) ground [including bare soil, small cut banks and sand piles]
Dead trees/snags
Native bee nesting boxes (for example for mason or leafcutter bees)
Apiaries (managed honey bees)

8. A safe, year-round, reliable source of water is needed by honey bees. Water supplies need to be protected from contamination by pesticides or other pollutants. Is substantial, safe and accessible water available for bees continuously during the dry summer months? Check all that apply (minimum requirement: 1)

River
Pond
Irrigation, rain water collection
Garden water features
Other

9. Best Management Practices (BMP) being used to minimize bee poisonings. Check all that apply (minimum requirement: 1)

I don't use any pesticides (insecticides, herbicides and fungicides).
I am an organic grower.
I use Integrated Pest Management (IPM), including--
    When needed, I only spray at dusk or after dark when bees less active.
    I never spray insecticides or fungicides on flowering plants, and I do not use pesticides with extended toxicity on plants that may come into bloom during the period of toxicity.

10. Other (check all that apply):

I grow crops that require bee pollination (List pollinated crops)--



I farm more than 3 insect pollinated crops per year.
I would be willing to work with local beekeepers and allow them to place their hives on my operation. Please contact me.
I am interested in increasing bee forage and in learning more about possible assistance and incentives. Please contact me (Pollinator Conservation Resource Center now includes links to native seed producers).
There are natural areas adjacent to my operation where bees can forage.
I am aware of wild honey bee colonies on or near my operation.

Other Comments Welcome!  We also encourage you to e-mail photos of your bee forage plantings to kathy@pfspbees.org. 

Click the following to submit your Bee Friendly Farmer Self Certification and to pay the tax-deductible $25 annual certification fee. Your annual fee helps fund cost-share assistance to growers planting additional forage for honey bees and other pollinators.

Refund Policy: If your self-certification is not accepted because you fail to meet the minimum criteria, your $25 certification fee will be refunded.

PFSP is indebted to Randy Oliver, Gene Brandi, Robbin Thorpe, Marla Spivak, Karen Strickler, Gerry Miller, Phil Giles, Sam Droege, Jeff Anderson, Dennis vanEnglesdorp and Mace Vaughan for their time and input in the development of the certification questionnaire.

Revised 042010