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Member's Name   Spouse's Name:
First Name
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First Name
Middle Initial
 
Middle Initial
Last Name
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Last Name
Mailing Address
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City
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State
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Zip Code
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Telephone
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Email
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Format as email address
From whom or where did you hear about Farm Bureau?
   
Select County for new membership or renewal for 2019 Dues
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Select One:


 
                                   If Renewing or Rejoining, please answer two questions:
                                 I am/was a member in (which County):
                                
My membership number is/was:
I will be
joining as:

(see definition below)

     
“FARMER MEMBER” shall mean anyone who is an owner, retired previous owner, operator or anyone who has a financial interest in a farm, whether cropland, pasture, or woodland, including ornamental horticulture and greenhouses. The financial interest may be as a resident or non-resident owner, a partner, a stockholder in an incorporated farm, a tenant, a farm manager, or an employee. The size of the farm, amount of income from the farm, or percentage of the member’s total income derived from the farm or other employment of the member will not be a factor in determining if the member is a “farmer member”, except that a lot only large enough for a house and garden will not be considered a farm.

(to be answered by FARMER MEMBER applicants only)
Type(s) of agricultural product(s) produced in your operation:
 
Check two:

Beef      Dairy     Poultry     Tobacco     Sheep     Fruits & Berries     Equine   

Other:

County Farm Bureau Dues:
   
Voluntary contribution to Farm PAC? (suggested):
A Political Action Committee that supports
political candidates who support agriculture

NOTE: You can contribute any any amount to Farm PAC
however the Minimum Contribution is two dollars.
If contributing, please enter an amount
equal to or greater than two dollars
 
Invalid format.

Format as dollars and cents (without the dollar sign)
The following are non-PAC Counties: BARBOUR, CALHOUN, GILMER, LINCOLN, RALEIGH, TAYLOR, WAYNE, WIRT

WHAT IS PAC?

Note: Contributions, gifts, or membership dues are not deductible as a charitable contribution for Federal Income Tax purposes. Please consult your tax professional regarding possible deductibility as a business expense.

I understand that I am applying for membership into the county Farm Bureau listed above and that once accepted, which occurs at the time a membership number is assigned to me, my membership is valid for twelve months and that my payment for dues is non-refundable.

I understand that Farm Bureau membership benefits are subject to change without notice.