Maryland Organic Food and Farming Association Winter Meeting 2016 Registration Form
Last Name of Member/Attendee 1
Your answer
First Name of Member/Attendee 1
Your answer
Last Name of Member/Attendee 2
Your answer
First Name of Member/Attendee 2
Your answer
Farm Name
Your answer
Address1
Your answer
Address 2
Your answer
City
Your answer
State
Zip Code
Your answer
Phone
Your answer
Alternate Phone
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Cell Phone
Your answer
Email 1
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Email 2
Your answer
Web Site
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Would you prefer an e-newsletter or print?
Are you interested in Volunteering?
Would you like to be listed as a member on the MOFFA web site?
Payment:
Annual MOFFA Dues (per farm or family)
Payment:
Meeting Fee
1
2
3
4
Quantity
Member Meeting Fee (per person) $5
Non-Member Meeting Fee (per person) $20
Total
Please enter the total ammount due. After Completing and submitting the form, please return to http://marylandorganic.org/join/ to make your secure payment to MOFFA
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