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Please tell us your first and last name.
First Name
Last Name
What is the name of your farm / business?
Describe your farm / agriculture activity. What type of farming? Are you a family farm, small commercial, large commercial, etc.?
How many people work for you? Include family, part-time, full-time, seasonal, etc.
What is your mailing address?
Street Address 1
Street Address 2
City
State
Zip Code
What is your email address?
Email Address
What is the best daytime telephone number to reach you at?
Daytime Telephone
What is the best evening telephone number to reach you at?
Evening Telephone
Please explain why you want to be a part of this program?
Orientation will consist of a Zoom session. What day / time generally works best for you?
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