Farm Leadership Council

* required fields

First Name:

*

Last Name:

*

Company:

Address:

*

Address 2:

Address 3:

City:

*

Province:

*

Postal Code:

*

Country:

*

Phone:

Fax:

Cell:

Email:

*

I hereby agree to allow my contact information to be used by the Farm Leadership Council for the purpose of membership lists, communications, database, etc.

Would you like to receive information by text messages

If yes, who is your cell phone service provider?:

Are you 18 years of age or older?

Are you actively engaged in farming?

Voting members must be 18 years of age or older and actively engaged in farming. If you are under 18 or not engaged in farming, you will be registered as a non-voting member. In that case you may proceed to the Membership Plan portion of the form.

Farm Size:

Age Range:

Type of Crop:

Education:

Designated Home Quarter:

RM/County *

Section *

Township *

Range *

Meridian *

Company Type:

(a) Farming Corporation