Form 5: Official County Farm Bureau Elected & Appointed Leader Form

75th Annual Meeting: Form 5
Official County Farm Bureau Elected & Appointed Leader Form

Deadline: October 29, 2025
County Farm Bureau*
Choose a county
Name of Person Submitting Form*

First NameLast Name
Position*
Phone Number*

Area CodePhone Number
Email*
example@example.com
I verify that this is an accurate listing of the County Farm Bureau at its Annual Meeting.
Date of County's Annual Meeting*

MonthDayYear
Date
President Name*

First NameLast Name
Email
example@example.com
Membership Number
Vice President 1 Name*

First NameLast Name
Email
example@example.com
Membership Number
Vice President 2 Name

First NameLast Name
Email
example@example.com
Membership Number
Vice President 3 Name

First NameLast Name
Email
example@example.com
Membership Number
Secretary Name*

First NameLast Name
Email
example@example.com
Membership Number
Treasurer Name*

First NameLast Name
Email
example@example.com
Membership Number
Director 1
Director 1 Name*

First NameLast Name
Email
example@example.com
Membership Number
Director 2
Director 2 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 3
Director 3 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 4
Director 4 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 5
Director 5 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 6
Director 6 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 7
Director 7 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 8
Director 8 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 9
Director 9 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 10
Director 10 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 11
Director 11 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 12
Director 12 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 13
Director 13 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 14
Director 14 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 15
Director 15 Name

First NameLast Name
Email
example@example.com
Membership Number
Director 16
Director 16 Name

First NameLast Name
Email
example@example.com
Membership Number
Type signature of secretary*
Should be Empty:

Official County Farm Bureau Elected & Appointed Leader Form

Director 1

Director 2

Director 3

Director 4

Director 5

Director 6

Director 7

Director 8

Director 9

Director 10

Director 11

Director 12

Director 13

Director 14

Director 15

Director 16