Berkshire-Pioneer RC&D

Identify the primary agricultural type associated with your farm: *

Identify the secondary agricultural type associated with your farm:

Please provide a brief description of your farming operation: *

Is your farm located on any kind of agriculturally preserved and restricted land such as Agricultural Preservation Restriction (APR) land? *

Yes No

Are you currently enrolled in the MA Dept. Of Agricultural Resources Farm Energy Discount Program? *

Yes No

If no, why?

Not aware Not qualified Other

If other, please explain:

Enter your electric and/or gas rate (Found on your bill - ex. R1, C41, etc.): *

Electric:

Gas:

Have you received a farm energy audit through your utility company? *

Yes No

If yes, when? Within the past

2 years 2-5 years 5-10 years 10+ years

Have you taken advantage of rebates or other incentives for farm energy projects through your utility company? *

Yes No

If yes, when? Within the past

2 years 2-5 years 5-10 years 10+ years

Have you applied for any of the following energy related grants or assistance programs? (Please check all that apply.) *

None

USDA's Rural Development Renewable Energy and Energy Efficiency Grants or Guaranteed Loans

MA Clean Energy Center renewable energy grants

MA Dept. of Ag Resources Environmental Enhancement Program (AEEP)

Have you been awarded grants from any of the following energy related assistance programs? (Please check all that apply.) *

None

USDA's Rural Development Renewable Energy and Energy Efficiency Grants or Guaranteed Loans

MA Clean Energy Center renewable energy grants

MA Dept. of Ag Resources Environmental Enhancement Program (AEEP)

Please select any specific energy efficiency measures which you have implemented to date (check all that apply):

Aquaculture

Other (please describe):

Cranberry

Other (please describe):

Dairy

Other (please describe):

Forest Products / Logging / Lumber

Other (please describe):

Grains

Other (please describe):

Livestock

Other (please describe):

Maple Sugaring

Other (please describe):

Nurseries / Greenhouses

Other (please describe):

Poultry

Other (please describe):

Vegetable / Orchard

Other (please describe):

If your energy efficiency measures do not fit in the above categories please describe:

Please select any specific energy efficiency measures which you would like to implement (check all that apply):

Aquaculture

Other (please describe):

Cranberry

Other (please describe):

Dairy

Other (please describe):

Forest Products / Logging / Lumber

Other (please describe):

Grains

Other (please describe):

Livestock

Other (please describe):

Maple Sugaring

Other (please describe):

Nurseries / Greenhouses

Other (please describe):

Poultry

Other (please describe):

Vegetable / Orchard

Other (please describe):

Describe any additional energy efficiency measures you would like to implement:

Please describe any specific renewable energy technologies which you have implemented to date:

Please describe any specific renewable energy technologies which you would like to implement:

If you provide this information, it will assist us in determining your eligibility and potential scoring to apply for USDA/Rural Development REAP grant and loan program.

An agricultural producer is an individual or entity directly engaged in the production of agricultural products, including crops (including farming); Livestock (including ranching); forestry products; hydroponics; nursery stock; or aquaculture, whereby 50% or greater of their gross income is derived from the operations.

Are you an agricultural producer by this USDA/RD definition? (50% or greater of gross income is derived from agriculture)

Yes No

As an agricultural producer, did you produce agricultural products with a gross market value of:

Less than $600,000 in the preceding year?

Yes No

Less than $200,000 in the preceding year?

Yes No