Maryland Organic Food and Farming Association Winter Meeting 2018 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
Choose
MD
DE
VA
DC
PA
Zip Code
Your answer
Phone
Your answer
Alternate Phone
Your answer
Cell Phone
Your answer
Email 1
Your answer
Email 2
Your answer
Web Site
Your answer
Would you prefer an e-newsletter or print?
E-news
Print
Both
Are you interested in Volunteering?
Yes
No
Would you like to be listed as a member on the MOFFA web site?
Yes
No
Payment:
Annual MOFFA Dues (per farm or family)
One year Membership $25
Two Year membership $45
Student Membership $12
Payment:
Meeting Fee
1
2
3
4
Quantity
Member Meeting Fee (per person) $5
Non-Member Meeting Fee (per person) $20
1
2
3
4
Quantity
Member Meeting Fee (per person) $5
Non-Member Meeting Fee (per person) $20
Total
Please enter the total amount due. After Completing and submitting the form, please return to
http://marylandorganic.org/join/
to make your secure payment to MOFFA
Your answer
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