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Join Pennsylvania Farm Bureau

This form is for new members and renewals with information changes ONLY

Instructions
Online Membership Renewal involves two parts:

1) Your information and 2) Online credit card payment


    After submitting the form below with your information, you will be taken to a secure payment site (https) for credit card processing.
    After the credit card payment is processed, you will see a receipt screen to print. In 1-2 weeks, you will receive, in the mail, a membership packet containing membership cards which will have your assigned membership number printed on them.

    If you do not finish the online payment portion of the process, your membership will not be complete until you contact Member Relations at 717.761.2740 to make your payment.

Please note:
You will not be able to return to the online payment page
if you navigate away.


* Membership Payments are Non-refundable

First Name(*)(*)
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Last Name(*)(*)
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Name(*)
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Profession
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Spouse's Name
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Birthdate (yours)
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Birthdate (spouse's)
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Email Address(*)
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Farm Name
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Address(*)(*)
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City(*)(*)
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State(*)(*)
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Zip(*)(*)
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Township(s) you are located in
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Home Phone(*)(*)
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Work Phone
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Cell Phone
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Commodity Interest(s) - select all that apply

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Other Commodities - please explain
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Size of Farm Operation
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Political Party (optional)
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Signed Up by (optional)
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Referred by (optional)
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Reason for Joining PFB or other Comments
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Type of Payment(*)
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At this time, only credit card payments are accepted for online membership payments.


Please select your county below:

Membership for(*)




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Agent Name
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Agent Number
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Agent Email
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Agent Phone Number
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