EarthDance MOSES Conference Bus Delegation Interest Form
Thank you for your interest in traveling to the 2018 MOSES Conference with EarthDance!
Email address *
Name (first and last) *
Your answer
Company/ Farm Name
Your answer
Address (including city, state, zip) *
Your answer
Phone number *
Your answer
Which of the following best describes you? *
Including yourself, how many adults (ages 13+) are you requesting space for on the bus? *
How many children (0-12 years) are you requesting space for on the bus? *
Are you engaged in specialty crop production? Specialty crops are defined as fruits, vegetables, tree nuts, dried fruits, and horticulture and nursery crops (including floriculture). The following groups are not considered specialty crops: grains (corn, wheat, rice, etc.), oil seed crops (canola, soy bean, camelina, etc), bio-energy crops (switchgrass, sugar cane, etc), forages (hay, alfalfa, clover, etc.), field crops (peanut, sugar beet, cotton, etc.), and plants federally controlled as illegal drug plants (cannabis, coca). Honey, maple syrup and hops are eligible crops. *
If you are a specialty crop producer, briefly describe your operation.
Your answer
Which race/ ethnicity best describes you? *
Do you need a scholarship to enable you to attend the conference? Note: the questions below constitute our scholarship request process. If multiple individuals from your farm are applying to EarthDance for scholarships to attend the conference, please have each farmer fill out this entire form separately. *
If you requested a scholarship: What is your current involvement in farming?
Your answer
If you requested a scholarship: What are your farming goals?
Your answer
If you requested a scholarship: How do you hope to benefit from the MOSES conference?
Your answer
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