NAFEC-NATIONAL ASSOCIATION OF FARMER ELECTED COMMITTEES

www.nafec.org

NATIONAL ASSOCIATION OF FARMER ELECTED COMMITTEES

Membership Application/ Renewal Form

NAME:

ADDRESS:

CITY/STATE/ZIP:

PHONE NUMBER:

E-MAIL:

Would you prefer to have the newsletter sent electronically to you? Yes_____ No_____

Are you submitting an FSA-444 to your County FSA office for automatic dues withholding?    Yes*_____ No_____

If yes, please remember to send your personal information to NAFEC or have your FSA office do so.

_____ Committee member $35

_____ FSA employee or Associate member $20

_____ $3.00 per meeting ( 444 dues withholding only)*

* please check with your staff to set up your 444

If paying by check, please make payable to NAFEC

Please send membership information and/or questions and comments to:

Cole Sims , NAFEC Secretary/Treasurer

P.O. Box 471

Mer Rouge, LA 71261

Phone: 318-647-5005

Fax: 318-647-3889

e-mail – farmercole@msn.com