Alabama Forest Owners' Association (AFOA)
Census of Forest Landowners interested in lowering the cost of their health insurance.

There is no cost or obligation to join the census.

Name (First & Last) *
Your answer
Birthdate (mm/dd/yyyy) *
Your answer
Zip Code *
Your answer
Gender *
Coverage Tier (Level you are interested in) *
If you wish for AFOA to contact you regarding the health insurance once we receive enough potential participants please submit your email or your ID# located just above your name on the brochure.
Email (optional)
Your answer
ID# (optional)
Your answer
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