--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

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. 

CA State Assembly District:
CA State Senate District:
Congressional District:

Total farmable acres:
Acres available for beginning farmer:
Total farm/ranch size (acres):

Select the crops and/or livestock that you would like to see raised on your land (Hold CTRL to select all that apply)
Fruit Vegetables Herbs Nuts Vineyard Poultry/Fowl Goats/Sheep Cattle (Beef) Cattle (Dairy)

Select any of the following cropping methods or agricultural practices that you employ
Organic BIOS/BIFS Biodynamic Permaculture Promoting on-farm wildlife habitat Other
If other, please explain:

Would you require organic farming practices of a tenant? (Check if yes)

What type of business arrangement would you consider? Select all that apply.
Buy/Sell Cropshare Cash Rent Other Partnership

If you are interested in another type of business arrangement, please explain

Please describe your vision for the future use of your land.  This will help us describe the opportunity to aspiring farmers and land seekers.
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.

We/I are currently farming on the farm (Check if yes)
We/I are currently living on the farm (Check if yes)

If you were to lease the property, what would you expect to ask per acre?

Would you be willing to mentor or advise the entering farmer? (Check if yes)

Would you be willing to provide assistance with housing for the aspiring farmer?
If yes, please describe

If currently farming, please describe how you market your crops Standing agreement with wholesaler(s) Standing agreement with packer/commiss Informal agreement with wholesaler(s) Informal agreement with packer/commiss Farmer's Market Other direct market
If other, please describe

Do you have livestock? (Check if yes)
If yes:
- Are the livestock for lease?
- Are the livestock for sale?
- Please describe your livestock operation

Do you have farm machinery?:
If yes:
- Is the machinery for lease?
- Is the machinery for sale?
- Please describe the machinery you own

Describe all buildings and facilities on the property

Describe  the soil, the irrigation system and/or availability of water
Number of irrigated acres:

Does the property have any particular conservation or historic value? Adjacent to park Adjacent to stream/river Historic value Wildlife habitat Williamson Act Other
Describe any aspects of your farm that are of particular historic value
Are there any know environmental hazards on the property? (Check if yes)
If yes, describe environmental hazard

Are you a member of any of the following organizations? California Farm Bureau Community Alliance with Family Farmers Young Farmers and Ranchers California Women in Agriculture CCOF Other
Other membership organization:

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

Estimate Annual Farm Income
Estimated Value of Your Farm

Do you have long term care insurance?:
Do you have an estate plan completed? (Check if yes)
If yes, when was it last updated?

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

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

Family income level for the most recent 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/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