New Farmer Member Application 

Thank you for your interest in becoming a member of the Champlain Valley Farmer Coalition. Please submit the application below. Your application will be reviewed at our next board meeting (the first Wednesday of each month). We will be in touch to confirm your membership’s acceptance.


Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Business Name
Street Address *
Town/City *
State *
Zip *
Phone Number *
How did you hear about the Champlain Valley Farmer Coalition? *
Why would you like to become a member of the Champlain Valley Farmer Coalition? *
Type of Farm *
Farming Method *
Farm Size *
Number of Acres Owned/Operated *
Do you actively manage the production of crops/animals/pastures grown on all of these acres?  *
If no, are they leased to another farmer?
Clear selection
Statement of Membership: As a member of this organization, I acknowledge and support the goal of implementing innovative agricultural practices that enhance water quality, soil health, climate smart farming, and farm economic resiliency in the Champlain Valley. *
Required
Donations Welcome!
Membership in the Champlain Valley Farmer Coalition is free for farmers and individuals. If you would like to continue to financially support our mission, your donations are welcome and appreciated! Your gift of $100, $250, $500, or any amount of your choosing will help us to grow the educational programming and advocacy we provide.

You may make your donation online or send a check made payable to the Champlain Valley Farmer Coalition, 7056 US-7, North Ferrisburgh, VT 05473.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report