FARMER REGISTRATION SURVEY FORM
We have the interest of local and mechanized farmers at heart
Name
*
First Name
Last Name
Phone Number
*
-
Aree
Phone Number
E-mail
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Which of the services you want us to provide?
*
Extension Services
E-Commerce Services
Market Price Update
Farm Mechanization
Weather Update
What platform would you prefer?
*
Website
email
IVR
SMS
What challenges are you facing as a farmer:
*
Submit
Should be Empty: