If you are a human and are seeing this field, please leave it blank. Fields marked with a * are required Farm Member (Based on gross ag-income) $75.......farmer membership ($1-$25,000 ag-income) $100.....farmer membership ($25,001-$75,000 ag-income) $125.....farmer membership ($75,001-$200,000 ag-income) $175......farmer membership ($200,000 ag-income) $35........retired farmer, over 65 Supporting Members (based on age) $60.....adult supporting member $25.....student (under 24) supporting member $35.....seniors, over 65 supporting member Payment is easy! Make payment with Credit Card via PayPal after submitting the form below with your information. Once you click 'submit' you will be routed to the PAYMENT page. If online payments are not for you, please call the office at 603-224-1934 with your credit card information OR mail a check. It's that easy to join Farm Bureau! Are you a renewing member? * Yes No Select First Name(s) * Last Name(s) * Farm Name Mailing Address * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Post Code * Phone Email * Commodities/Services - Check all that apply Aquaculture Ag Service Provider Agri-Tourism Beef Cattle Christmas Trees Commercial Fishery Corn/Grain Dairy Equine Farm Stand Farmers' Market Participant Flowers/Herbs Forage Crops/Hay Forest Products Fruit/Berry Goats Greenhouse Production Honey Landscaper Maple Nursery Pork Poultry/Eggs Sheep Specialty Foods Turf Vegetables Other Livestock Other Product Are you interested in any of the following programs or committees? Young Farmers (for ages 16-35) Associated Women (for women with a passion for agriculture) Ag in the Classroom Policy Development Membership Special Events Board Member Promotion/Education Government Affairs Veterans in Agriculture Committee Degree of Farming Full-time Farmer Part-time Farmer Retired Farmer Agribusiness Ag Professional Farm Employee Ag Student Select if applicable Number of Acres Owned/Leased 0-49 50-99 100-249 250-499 500 and over Select if applicable Do you have land under Current Use Taxation Yes No Are you a certified organic producer? Yes No Are you a U.S. Veteran Yes No Friday Review - legislative updates, please choose an option: E-mail me to save postage and paper I will log onto the NHFB website and access the publication there Send me a hard-copy via USPS I do not wish to receive The Friday Review Solicitor (who encouraged you to join Farm Bureau) If you are a human and are seeing this field, please leave it blank. Payment Method * I will use PayPal on the next page (after I submit this form) I will mail my check to the Farm Bureau I will call the Farm Bureau office and use my credit card Select
