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
Street Address (Farm)
City (Farm)
State (Farm)
Zip Code (Farm)
Type of Operation

Other
Type of Work Needed

Other
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?
Do you currently provide worker housing?
Do you currently provide worker transportation?
How soon are you looking to start?
Anything else we should know about your labor needs?
Farm Summary
Should be Empty: