National Women In Agriculture Registration Form

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National Women In Agriculture Registration Form

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* Indicates required question

Name (last, first format) *

Your answer

Address ( city, state, county, & zip code) *

Your answer

Email Address *

Your answer

Phone Number

Your answer

Race *

White

Black or African American

American Indian or Alaskan Native

Asian

Pacific Islander

Prefer not to say

Other:

Required

Farm Ownership *

Own

Rent or Lease

Farm Size (per USDA specifications) *

$1,000 - $9,999

$10,000 - $99,999

$100,000 - $249,999

$250,000 - $499,999

$500,000 - $999,999

$1,000,000 or more

Other

Required

Veteran Status *

Yes

No

Branch (Veteran Status)

Your answer

What Services Are You Requesting for NRCS? *

Your answer

Signature *

Your answer

Submit

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