Entry Form

Entry deadlines:

Forms must be received by the state Farm Bureau office no later than September 4, 2009.
States must submit the entries to AFBF by the end of business on September 18, 2009.
Announcement of winners will be made no later than October 16, 2009.

Entries are limited to two single side pages NOT including this page.
Electronic submissions are preferred. 


County Farm Bureau: State:

Office Address:

Phone:   Fax:   Email:  

Office Hours:

Number of members:         Rural:         Suburban:         Urban:

County President:

President's Home Address:

President's Phone: Cell phone:

President's email:



Name of person completing this form:


Person to contact if this entry is selected by AFBF as a winner:

Name:

Address:

Phone: Fax: E-mail:



- Official Use Only -
Entrant #
1. Title of Activity:


2. Enter Category: (check only one)
Education and Ag Promotion (EAP)
Leadership Development (LD)
Member Services (MS)		 Policy Implementation (PI)
Public Relations & Information (PR/I)
 
3. Please provide a brief summary of the activity. (Not to exceed 70 words.)

0 of 70 words

4. Please provide a brief response for each of the following:
    

1. Briefly state the purpose of the activity.


2. Describe the program keeping in mind that the judges have not seen or participated in the activity. 


3. What were your objectives for the activity? What did you want to accomplish? Who was the target audience?


4. What were the results of the activity?

Caution: Copy security code exactly!
If filled in incorrectly, you will have to completely fill out the form again.