Pennsylvania Farm Bureau - Association for Farmers and Rural Families in Pennsylvania

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If you choose not to pay your dues over the Internet, you may print out and mail the application below with a check or money order made payable to Pennsylvania Farm Bureau.

Printable application


	Membership Application Form

After completing the form below, you may use VISA, MasterCard, American Express, or Discover to pay for your membership dues.
In order to keep your sensitive financial information safe, after completion of this form you will be directed to Paypal's secure site to pay for your membership.
Your credit card information will be processed by Paypal's secure site, but not stored by them, and the funds will then be forwarded on to PA Farm Bureau. It is a once and done secure transaction.
You may also use a Paypal account, if you have one or care to open one.

IT IS NOT NECESSARY TO HAVE A
PAYPAL ACCOUNT TO PAY THE MEMBERSHIP FEE
WHEN USING THIS E-FORM

*Must be filled in.

Applicant Information
First Name*
Middle Name
Last Name*
Profession*
Type of Membership
Birthdate	(mm) - (dd) - (yyyy)
Spouses Name
Farm Name
Address*
City*
State*
Zip*
County*
Township
Home Phone No.*	Area Code -
Work Phone No.	Area Code -
FAX No.	Area Code -
Cell No.	Area Code -

Email
Commodity Interest *Hold down shift key to select multiples

Size of Farm Operation:

Political Party:

Reason for joining PFB:

*Nationwide Agents: Please fill out information below. . .

Agent Name
Agent #
Agent E-mail
Agent Phone #

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	Resources

Publications and Brochures
Farm Bureau Brochures
Country Focus Highlights

Ag Information
   Ag Facts & Stats
   County Ag Statistics
   Last USDA Ag Census
   Glossary of Ag Terms
   Ag Events of Interest

Links of Interest
   American Farm Bureau
   PFB Members Websites
   Related Ag Links
   FB Country
   PA Dept of Ag

Membership Application Form