YF&R Committee Application

YF&R Committee Application
Regional Manager:
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Spouse Name

First NameLast Name
Spouse Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Spouse Email
example@example.com
Spouse Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Region applying for
Applicant(s) biography (3-5 sentences written in third person for applicant and spouse):
Briefly describe your connection to agriculture (e.g., crops, livestock, ag business):
Describe your involvement with Farm Bureau (include spouse if applicable):
Please list leadership roles in Farm Bureau or other organizations and/or groups you have been a member (include spouse if applicable):
Why are you interested in participating in the NEFB YF&R Committee?
What are your expectations and goals for the committee/program?
What is the most critical issues facing agriculture in the next 5-10 years?
Please send the link to the YF&R Committee County Nomination Form to your County President and/or your Regional Manager.
Should be Empty: