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First Name
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Last Name
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Company/Farm Name
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Address
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City
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State/Province
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Country
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Postal/ZIP Code
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Phone
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Fax
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Email
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Please choose the username you want to be reference this
account by... eg: John Smith might use jsmith... usernames
may be visible to the public and CANNOT be changed! Also
choose the password you want to use to access your account.
Both must be between 3 and 16 characters and must consist of
letters, numbers, dashes or periods... NO SPACES!
Usernames and Passwords ARE CaSe-SEnSiTiVe!
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Username
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Password |
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NOTE: The following fields are optional, but we would appreciate your input as it will help us customize the content of the site to better match your interests.
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How did you find out about Agri-ville?
Please specify
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What level of formal education do you have?
If Other, please specify
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How many years have you been involved in managing a farm operation?
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Which of the following best describes your gross farm receipts for the last reporting year from agricultural products sold and subsidies?
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What agriculture sectors make up the majority of your farm receipts?
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Do you want to receive the member newsletter?
Yes or No |
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