2025 FARMER Dinner

FARMER 2025 Dinner Registration
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Corporate contributions are prohibited by law.
Contributions are not tax deductible.
Will you be attending the FARMER Dinner?*

YesNo
If you are attending the event, you must make a selection

Grassroots $175Cultivator $275Tiller $1,000Harvester $2,000
Your Guest's Name

First NameLast Name
I am unable to attend the FARMER Dinner, but I would like to make a donation of:
Minimum credit card charge is $10
Would you consider adding 3% to your amount to cover processing fees?

YesNo
Additional Cost of Processing Fee
Amount x .03
Total

Additional Information
For ticket purchases over $250, we are required by law to collect information about donors' employment.
Are you self employed?*

YesNo
Employer name
Employer address

Street Address

Street Address Line 2

CityState

Zip Code

Payment total*

USDFor FARMER dinner tickets or donation

FARMER 2025 Dinner Registration