Participant One
 
 
 
 
First Name
 
 
Last Name
 
 
 
Email*
 
 
 
Participant 2
 
 
 
 
First Name 2
 
 
Last Name 2
 
 
 
Email 2
 
 
 
 
 
 
Street 1
 
 
City
 
 
 
State
 
 
Zip Code
 
 
 
County
 
 
Mobile Phone Number
 
 
 
Communication Preference
 
 
 
Check here if you prefer text modules instead of online modules.
 
 
 
 
 
 
Check all that describe your agriculture operation:
 
Crops
 
 
 
List
 
 
 
Dairy
 
 
 
Forest Products (logging, sawmill, etc.)
 
 
 
Livestock (beef, hoges, poultry, goats, sheep, horses, etc.)
 
 
 
Specialty Crops (fruits, vegetables, maple syrup, hops, nursery plants, Christmas trees, vineyard etc.)
 
 
Other
 
 
 
 
Descibe
 
 
 
 
 
 
List additional details (commodities, size, years involved, family members involved, etc.):
 
 
 
 
 
Please check all categories below that describe your agriculture operation:
 
 
 
Young - Defined as farmers or ranchers who are age 35 or younger
 
 
Beginning Farmer - definied as farmers or ranchers who have 10 years or less of experience
 
 
Not Farming - do not own or operate a farm but interested in farming in the future
 
 
 
 
 
 
 
 
Indicate if you:
 
 
 
 
 
Have (or plan to be) part of an existing farming operation
 
 
 
Have (or plan to) start a new operation
 
 
 
Describe
 
 
 
 
 
 
 
 
 
Are you completing AgBiz Masters to fulfill Farm Service Agency borrower training requirements?
 
 
 
 
 
 
 
 
What do you hope to gain from AgBiz Masters (goals, aspirations, expected outcome)?
 
 
 
 
 
 
 
 
If you have been recruited by a specific organization, please let the organization below.