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Today is Saturday, February 4, 2012
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Landowner Workshop Registration
Your Email Address:
Last Name:
First Name:
Address Line 1:
Address Line 2:
City:
State:
-International-
Alabama
Alaska
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Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
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Louisiana
Maine
Maryland
Massachusetts
Michigan
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Mississippi
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New Mexico
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North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, D.C.
West Virginia
Wisconsin
Wyoming
Zip Code:
Telephone Number:
Work Telephone Number:
Names of Attendees:
Please fill in the following information:
Do you own land?
Yes
No
If yes, State:
-International-
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
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
Washington, D.C.
West Virginia
Wisconsin
Wyoming
Acres Owned:
Tillable Acres:
Pasture Acres:
County(s):
Workshop location you are registering for:
Make Selection
Palm Desert, California - February 20, 2012
Fort Myers, Florida - March 8, 2012
Do we currently manage any of your farms?
Yes
No
If yes, what is your farm number or farm manager?
If you are not currently a client of Farmers National Companies farm management services, please complete the payment information below to register.
$35.00
Advance Registration - per individual
$50.00
Advance Registration - one individual and one child
$45.00
Advance Registration - two individuals
$60.00
Advance Registration - two individuals and one child
Please ckeck one of the following payment options:
Check here for check payment to:
Farmers National Company
11516 Nicholas Street, Suite 100
P.O. Box 542016
Omaha, NE 68154-8016
Credit card payment:
General:
Other/Comments
Questions you would like to be answered at workshop:
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