Application Form


Entry deadline:
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.
Announcements of winners will be made no later than October 16, 2009.


Title of entry submitted:


Name:

Date of Submission:

Address:

City:       State:       Zip:

Phone:            E-mail:

- Official Use Only -
Entrant #
Category of entry:
AG Equipment
Workshop
Cropping Systems
Buildings 		Safety/ Health/ Accessibility
Livestock/ Equine (Animal Agriculture)
Marketing/ Management
Conservation/ Improved Efficiencies


Idea Description:
Describe your idea explaining the concept, how it works and, where applicable the materials used and construction methods. Tell how much time and money it has saved you, and explain how it affected your net income. Maximum of 500 words.


Summary Statement:
Summarize your idea in 50 words or less. This information will be used in promotional materials.

0 of 50 words


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


Please remember to submit 2 color photos, either electronically or on a CD, to your state contact.