County Farm Bureau and Illinois Farm Bureau

APPLICATION AND MEMBERSHIP AGREEMENT

QUALIFICATIONS ❑ Individual Farm Owner/Operator: ________Acres in _____________________County.

❑ Gross farm income $2,500 per year or more

❑ This is an individual membership ❑ This is an joint membership (requires both signatures and birthdates)

❑ Does not own or operate farm:

❑ Occupation: _________________________________________

 Amount received from applicant $___________ Recommended by _____________________________________

 Date ______________________

 Name (full)  _________________________________ Spouse full name______________________________________________

 Address (City State/Zip Code Township)

_____________________________________________________________________________________________________________________________________

Home phone________________  cellular Phone_____________ email address_________________

Birthdate ____________________________ Spouse Birthdate____________________________

Our goal is to maintain an organization through which farm people and others can think, act,

and work together to strengthen agriculture’s role and influence as a vital part of a strong and

prosperous economy in a free America. We work to better the conditions of those engaged in

agriculture, improve the grade of agricultural products, and develop a higher degree of efficiency

in the production of agricultural products.

I believe in and support these goals and purposes and seek to promote them by joining this

county Farm Bureau.

I hereby apply for membership in ________ County Farm Bureau and the Illinois Agricultural

Association. This application is for the membership year beginning _______________________,

20___, and ending _______________________, 20___, and from year to year thereafter, so

long as the membership dues are paid in advance. Such membership is subject to the bylaws

of these organizations. The membership dues of $_________* for the first membership year

are paid herewith. I agree to pay membership dues in the total amount fixed in the bylaws

of the county Farm Bureau and in the bylaws of the Illinois Agricultural Association for each

succeeding membership year in advance so long as this agreement remains in effect.

I understand that $3.00 of my annual membership dues is for a year’s subscription to the

Illinois Agricultural Association’s official publication as checked: (X) FarmWeek (designed

for farm operators) or ( ) Partners. Also, $1of my annual membership dues is

for a year’s subscription to From the Ground Up, the official publication of

my county Farm Bureau.

I understand that this application for membership is subject to acceptance by the county

Farm Bureau board and the Illinois Agricultural Association. In the event this application is

not accepted, the membership dues paid herewith shall be refunded. Further, the county

Farm Bureau board has the authority to classify my membership in accordance with the

bylaws of the county Farm Bureau and the Illinois Agricultural Association on the basis of

the personal information contained in this application.

Either party may terminate this membership agreement as of the end of any membership

year by notice in writing to the other party during the last 60 days of such year.

* Membership dues are not tax deductible as charitable contributions.

Signature of Applicant ___________________________________________________