Stoneville® Legacy Club™ Sign-Up:
Plant Stoneville Cotton Seed. Rank in the top 10% of your state for yields.
Score an all-expenses-paid beach escape.
Please answer the following questions to complete your qualification form for Stoneville Legacy Club.
Name: *
Your answer
Spouse Name (if applicable):
Your answer
Business Partner Name (if applicable):
Your answer
Business Partner Spouse Name (if applicable):
Your answer
Farm Name *
Your answer
Address: *
Your answer
City: *
Your answer
State: *
ZIP Code *
Your answer
Home Phone: *
Your answer
Mobile Phone:
Your answer
Email: *
Your answer
Please keep the above information for future Stoneville Legacy Club qualification and communication. *
Required
I would like to receive emails from BASF with information that affects my crops, and products, offers or services that can help support my business. *
Required
BASF Seed Advisor Name: *
Your answer
BASF Seed Retailer: *
Your answer
City: *
Your answer
State: *
Gin(s) *
Your answer
Name for plaque: *
Your answer
Business partner name for plaque:
Your answer
If first-year member(s), indicate size for jacket(s): (one jacket per member please): Men's sizes (select as many as necessary)
For business partner, if first-year member(s), indicate size for jacket(s): (one jacket per member please): Men's sizes (select as many as necessary)
Next
Never submit passwords through Google Forms.
This form was created inside of Periscope.com. Report Abuse - Terms of Service