JEFFERSON COUNTY FARM BUREAU ASSOCIATION AG AMBASSADOR APPLICATION

JEFFERSON COUNTY FARM BUREAU ASSOCIATION AG AMBASSADOR APPLICATION
Refer questions to Tabi Johnson, County Coordinator at 573-619-2668 or jeffersonfb@kfb.org. We are accepting the electronic jotform application only. Please do not mail or drop off an application at the Farm Bureau Financial Service office.

Please note: A student's parents do not have to be Farm Bureau members, but if there is a tie in the selections, the Farm Bureau student has first priority.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Graduation Year
High School Currently Attending
Will you be attending college/technical school?
Major
Years in FFA or 4-H:
Please explain why you would like to be an Ag Ambassador for Jefferson County Farm Bureau Association:
Why is it important to advocate for production agriculture in today’s environment?
Please describe briefly what you know about the Jefferson County Farm Bureau Association:
Commitment Statement:

I understand that to be an Ag Ambassador I must be and remain a student in good standing at my high school, and in the community at large. I also understand that I must attend a minimum of 75% of the board meetings and events to be eligible for the Scholarship Award of $2,000.
Check the box below to indicate that you agree to the commitment statement above and that you are ready to submit your application
Should be Empty: