Please enable JavaScript in your browser to complete this form.Membership Information - Step 1 of 3Name(s) *FirstLastNH Farm Bureau Membership # *Update my contact and/or agriculture informationI would like to update my informationI do not need to update my information (proceed to checkout)Farm NameEmail *I do not have an email addressI do not have an email addressAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *NextDegree of FarmingSelect one...Full-Time FarmerPart-Time FarmerRetired FarmerAgribusinessAg ProfessionalFarm EmployeeAg StudentNot a FarmerNumber of Acres Owned/LeasedSelect one...0-4950-99100-249250-499500+Do you have land under Current Use Taxation?YesNoPrimary Commodity Other Commodities/Services - Select all that applyAquacultureBeef CattleChristmas TreesCommercial FisheryCorn/GrainDairyEquineFarm StandFlowers/HerbsForage Crops/HayForest ProductsFruit/BerryGoatsGreenhouse ProductionHogsHoneyLandscaperMapleNurseryPoultry/EggsSheepSpecialty FoodsTurfVegetablesAg Service ProviderAgri-TourismCertified OrganicFarmers' Market BoothOther Commodities (if not listed)NextAre you intersted in any of the following programs or committees?Board MemberPolicy DevelopmentVolunteeringGovernment AffairsYoung Farmers (16 - 35)MembershipAg in the ClassroomPromotion & EducationAssociated WomenAre you a United States Veteran?YesNoWould you like to recieve the Friday Review, NHFB's weekly legislative bulletin? *Must provide email addressYesNoAre you interested in farm or auto insurance through our partners at American National Insurance?Yes, please have an agent contact me!No, thank you.Who encouraged you to join Farm Bureau? *If signing up as an American National Insurance Client, please list your Agent. List NHFB Website if no solicitor. Membership Level *Farmer Member ($1 - $25,000) - $ 75.00Farmer Member ($25,001 - $75,000) - $ 100.00Farmer Member ($75,001 - $200,000) - $ 125.00Farmer Member ($200,000+) - $ 175.00Retired Farmer - $ 35.00Supporting Member - Adult - $ 60.00Supporting Member - Retired - $ 35.00Student Member - $ 26.00Please select your level of Farm Bureau membership. Farmer Membership based on gross ag income: ($1 - $25,000) $75 ---- ($25,001 - $75,000) $100 ---- ($75,001 - $200,000) $125 ---- ($200,001+) $175. Supporting Members: Adults $60 ---- Student $26 Retired Farmer/Supporter $35. To pay with check, submit this form and disregard online payment form. Please make checks out to NH Farm Bureau and mail to 295 Sheep Davis Road, Concord, NH, 03301Submit
