General Farmer Interest Form

Farmer Interest Form
Applicant Name

First NameLast Name
Email:
example@example.com
Phone Number:
Please enter a valid phone number.
Name of Farm:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please provide a summary of the project you are seeking funds for:
How much funding are you requesting?
Farm Website (if applicable):
If "Other", Please Explain:
Describe your current financial position, including any financial hardships, and explain how this grant will help sustain your farm operations while awaiting reimbursement:
Do you qualify as a socially disadvantaged farmer under the USDA definition?

YesNoUnsure
How would you categorize your farm?

Certified OrganicOrganicRegenerative Organic CertifiedRegenerativeConventionalOther
List the primary crops and products grown on site:
How many acres under management for the entire farm/ranch?
How long has the farm been under your management?
Do you currently have a Conservation Plan or Carbon Farm Plan? If so, tell us which one and describe.
Please select which of the following conservation practices are currently implemented on your farm

Conservation CoverConservation Crop RotationContour Buffer StripsCover CropField BorderFilter StripForage and Biomass PlantingGrassed WaterwayHedgerow PlantingHerbaceous Wind BarriersMulchingMultistory CroppingNo-TillNutrient ManagementPrescribed GrazingRange PlantingReduced-TillRiparian Forest BufferSilvopastureStrip-CroppingTree/Shrub EstablishmentVegetative Barrier EstablishmentWindbreak/Shelterbelt EstablishmentOther
What's the timing of the proposed project?
When is the funding needed by?
Is there additional information you would like to provide?
Should be Empty: