McLean County Farm Bureau Membership Application

McLean County Farm Bureau Membership Application
Name*

First NameLast Name
Select your membership type*

Entity/Organization/BusinessIndividual (can include spouse/civil union partner)
Farm/Business Name (if applicable)
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Primary Residential Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you want to include a spouse/civil union partner on your membership?*
Spouse/Civil Union Partner Name

First NameLast Name
Date of Birth

MonthDayYear
Date

Membership Type
Farming/Agriculture Involvement*

I am a farmer/farmland owner with $2,500 or more in farm incomeI work fulltime on a farm or for an agriculture-related businessI do not work in agriculture
Are you a full or part time employee of Illinois Farm Bureau or COUNTRY Financial?*

YesNo

Membership Type - Associate
Annual Membership Dues: $20.00
Dues Agreement*
Membership Type - Professional Voting
Annual Membership Dues: $56.00

Membership year starts Dec. 1 & dues will be prorated quarterly
Dues Agreement*
Membership Type - Regular Voting
Annual Membership Dues: $56.00

Membership year starts Dec. 1 & dues will be prorated quarterly
Dues Agreement*

Membership Agreement
McLean County Farm Bureau® and Illinois Agricultural Association®

Our goal is to maintain an organization through which people work together to strengthen agriculture. I believe in this cause and seek to further it by joining. I am applying for membership with the McLean County Farm Bureau and the Illinois Agricultural Association for this membership year, and from year to year thereafter as long as dues are paid in advance. The membership dues of $20.00* are for the first membership year.

This application is subject to acceptance by the McLean County Farm Bureau board and the Illinois Agricultural Association. I agree to pay membership dues in the amount fixed in the bylaws of the McLean County Farm Bureau and the Illinois Agricultural Association for each succeeding membership year in advance so long as this agreement remains in effect. In the event this application is not accepted, the membership dues paid will be refunded. The McLean County Farm Bureau reserves the right to re-classify my membership in accordance with the bylaws of the McLean County Farm Bureau and the Illinois Agricultural Association. This agreement can be terminated by either party by supplying written notice to the other party 60 days prior to the end of the membership year, but membership dues are not refundable.

* Membership dues are not tax-deductible as charitable contributions. The dues include a subscription to either FarmWeek or Partners publication ($3.00) and to the McLean County Farm Bureau publication (in those counties where applicable). The cost of the subscriptions cannot be deducted from the membership dues.
I understand that this electronic application is being used in lieu of a paper application. This electronic application constitutes an electronic record which will serve as the sole record of my application. An authentic and reproducible copy will be retained electronically.*
Applicant Signature*

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Please verify that you are human*
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McLean County Farm Bureau Membership Application

Membership Type

Membership Type - Associate

Membership Type - Professional Voting

Membership Type - Regular Voting

Membership Agreement