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Diversity Bread ®

Diversity Counts

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Diversity Bread®Licensing Application Form

This is a digital submission form for licensing Diversity Bread, made in accordance with the Baking as Lifestyle Medicine (BALM) Protocol.

Before You Begin: Key Requirements

Before you apply, we would normally have worked with you to develop your Diversity Bread®, so the application below is the final step in confirming that your bread meets the requirements rather than the beginning of the process.

To qualify for your formula to carry the Diversity Bread™ license, please use this quick check that your bread meets the following criteria:

Of course they can just come up with it and submit it

☐ I am an artisan or microbakery (not a supermarket or factory)
☐ I bake with a live sourdough starter (not commercial yeast)
☐ My Diversity Bread® ferments using a natural sourdough ( containing naturally diverse LAB and wild yeast) and a fermentation process that adds up to at least 12 hours ( this can include leaven / starter and bulk subject to approval.)
☐ I use a minimum of 20% Diversity Blend Flour® in each licensed loaf from a registered mill
☐ My flour is glyphosate-free (preferably regenerative or organic)
☐ I understand and follow the Principles of The BALM Protocol
☐ I will include a QR code on every Diversity Bread® product to educate my customers
☐ I will not make health claims
☐ I agree to pay the correct licence fee based on my production volume
☐ I understand this licence protects artisan bread from industrial misuse

Please note that if in a food establishment If served in a restaurant, café, or food business, bread must be paired with a fermented or probiotic-rich accompaniment (e.g., cultured butter, live yogurt, kimchi) in accordance with the key principles of the BALM Protocol.

By submitting this form, you confirm that your bread aligns with these requirements.

Application Form

Diversity Bread Licensing Application Form

Section 1: Applicant Information

Maximum file size: 2MB

Section 2: Bread Submission

Does your bread contain at least 20% Botanical Blend Flour?

List all flours used and their percentages:

Organic/Regenerative
plus1 Add minus1 Remove
Organic/Regenerative
plus1 Add minus1 Remove

Maximum file size: 2MB

Section 3: Hydration & Bread Type

Bread type

Section 4: Serving & Pairing (For Food Establishments Only)

Will this bread be served in a restaurant, café, or food business?
If yes, select the accompanying fermented/probiotic-rich food

Section 5: Additional Information

Maximum file size: 2MB

Section 6: Declaration & Agreement

I confirm that this bread meets the Diversity Bread™ requirements, including: *
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