--None--Mr. Ms. Mrs. Dr. Prof. Hon. Mr. & Mrs. Mr. & Ms. Ms. & Ms. Sen. Hon. Pres.     First Name    
Last Name
Spouse/Partner First Name                    
Spouse/Partner Last Name

Farm or Organization Name:

Email 
(To receive information on new land opportunities and workshops)

Primary Phone    
Work phone    
Cell Phone

Mailing Address
City
State/Province
Zip
County:

How did you hear about us? Please be specific!

FarmLink is always advocating for better government policies for small farmers.  By filling in the following information, you can help us influence legislation at the state and national level.  Enter your zip code at www.congress.org to find out which districts you are in. 
     Congressional District (Federal)
     California State Assembly District
     California State Senate District

In which part of the state are you interested in farming?
(Hold CTRL to select all that apply).
North Coast Central Coast Southern CA North Central CA South Central Valley Sierra
If you are ONLY interested in specific counties, please indicate which counties.
Marin Sonoma Napa Lake Mendocino Humboldt Del Norte San Francisco San Mateo Santa Cruz Santa Clara San Benito Monterey San Luis Obispo Santa Barbara Ventura Los Angeles Orange San Bernardino Riverside San Diego Imperial Siskiyou Trinity Shasta Tehama Butte Glenn Colusa Sutter Yuba Yolo Solano Sacramento Contra Costa Alameda San Joaquin Stanislaus Kern Kings Tulare Fresno Madera Merced Modoc Lassen Plumas Sierra Nevada Placer El Dorado Amador Calaveras Alpine Tuolumne Mariposa Mono Inyo

What type of business arrangement would you consider?
Buy/Sell Cropshare Cash Rent Other Partnership
If you are interested in another type of business arrangement, please explain.

Please check here is you are only interested in
opportunities that include on-site housing.
(Note that this may significantly limit the options that FarmLink can offer you.)

What crops are you interested in growing? 
What livestock are you interested in raising?
Fruit Vegetables Herbs Nuts Vineyard Poultry/Fowl Goats/Sheep Cattle (Beef) Cattle (Dairy)

Would you be interested in working with a retiring farmer
who would serve as a mentor or advisor? (Check if yes)

What type of farming practices do you employ or plan to use?
Organic BIOS/BIFS Biodynamic Permaculture Promoting on-farm wildlife habitat Other
If other, please explain. 

Summarize your educational and experiential background.
Agriculture-related college degree Farm/Crop management (3 years or less) Farm/Crop management (over 3 years) Formal apprenticeship Informal apprenticeship General college degree General farming (less 3 years) General farming (over 3 years) Other experience/license/education

Please tell us in detail about your skills, experience, and/or
education related to agriculture.  This information may be
provided to a landowner, so consider this a chance to advertise yourself!
NOTE: This form cannot be saved.  To avoid losing your work, we recommend completing this question in a separate word document and copying and pasting your response into the form.
 

Describe any farm equipment or machinery that you currently own.

Are you a member of any of the following organizations? Select all that apply. 
California Farm Bureau Community Alliance with Family Farmers Young Farmers and Ranchers California Women in Agriculture CCOF Other
If other, list here:

Are you willing to be contacted by the media regarding your involvement in the linking program? (Check if yes)

Year of Birth             
Gender --None--Female Male                              
Ethnicity American Indian/Eskimo Asian/Pacific Islander Black Hispanic Other White        

Spouse/Partner Year of Birth
Spouse/Partner Gender --None--Female Male
Spouse/Partner Ethnicity American Indian/Eskimo Asian/Pacific Islander Black Hispanic Other White

Describe your family income during the past year: --None--Under $10,000 $10,000-$20,000 $20,001-$35,000 $35,001-$50,000 $50,001-$100,000 $100,000 or more

Estimate your savings and/or equity: --None--Under $5,000 $5,001 - $15,000 $15,001 - $25,000 $25,001 - $50,000 $50,001 - $100,000 $100,001 - $250,000 $250,001-$500,000 $500,001-$1,000,000 $1,000,000 or more