Paleo Approved Renewal II

Please select your certification:*
Company Name

(company name) seeks permission to use the “Certified Paleo” Trademark, hereinafter referred to as the logo, on the attached list of product(s).
We guarantee that each product meets the strictures of the Paleo Diet as outlined by the Paleo Foundation, are maintained on pasture, not confined in pens or feedlots, have continuous access to forage, and are not given hormones or sub-therapeutic antibiotics.
We guarantee that each product meets the strictures of the Paleo Diet as outlined by the Paleo Foundation, are maintained on pasture, not confined in pens or feedlots, have continuous access to forage, and are not given hormones or sub-therapeutic antibiotics.
Name
Title
Signature
Date
MM slash DD slash YYYY
Street Address City State ZIP Code
Phone
Fax
Website URL
Email
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Information submitted for certification purposes will be kept in strict confidentiality.
Products being submitted for Renewal

Product	Product

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Standards vary by individual animal and by operation type.

Ingredients	Suppler	Supplier email / phone

Ingredients	Suppler	Supplier email / phone

Ingredients	Suppler	Supplier email / phone