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Full Name
First Name
Last Name
E-mail
*
Phone Number
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Area Code
Phone Number
Farm/Company/Organization Name
*
Website Address
Recommended by (if applicable)
Which best describes you?
Family or Commercial Farm
Agribusiness Company
Agricultural Lender
Urban Agriculture
Industry Association
Professional Individual
Other
Primary commodity/business interests:
Brief description of your business:
How did you learn about the Virginia Agribusiness Council?
Council member
Association with another industry organization
Internet
Industry publication
Communication from the Council
Other (specify in comments below)
Comments:
E-mail
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