H-2A Labor Request Form

H-2A Labor Request Form

Provide your farm details and labor needs to get started.
Farm / Business Name*
Contact Name*

First NameLast Name
Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Farm Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
State*
Type of Operation*

Field CropOrchardVineyardNurseryGreenhouseLivestockDairyGeneral FarmOther
Type of Work Needed*

Field Crop WorkOrchard WorkVineyard WorkNursery WorkGreenhouse WorkLivestock WorkDairy WorkGeneral Farm LaborOther
Brief Description of Work Needed*
Labor Need (e.g., specific tasks, skills, or experience required)*
Number of workers needed*
Start date needed*

MonthDayYear
Date
End date needed*

MonthDayYear
Date
Estimated weekly hours*
Have you used H-2A before?*

YesNo
Do you currently provide worker housing?*

YesNo
Do you currently provide worker transportation?*

YesNo
How soon are you looking to start?*

ImmediatelyWithin 30 days1–3 monthsPlanning ahead
Anything else we should know about your labor needs?
Should be Empty: