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20%

I am...
Please select your membership type below.*
- FULL-TIME FARMER (Farming is Primary Source of Income or Activity) - $125
- PART-TIME FARMER (Farming is a Secondary Occupation) - $75
- YOUNG AG PROFESSIONAL (Young agriculturalists no longer in 4-H/FFA) $35
- FRIEND OF FARMER (Non-Farmer supporting Agriculture) - $35
- 4-H & FFA MEMBERS (currently enrolled students) - FREE
Are you an insurance agent, or are you working with an insurance agent?*
- Yes
- No
Insurance Information
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Agents
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Agent ID
Agent Name*
Agent Number*
Agent Email*
Agent Phone Number*

Contact Info
Membership Number*
*
First Name Middle Name Last Name
Birthdate
MM slash DD slash YYYY
Spouse's First Name
Spouse's Last Name
Spouse's Birthdate
MM slash DD slash YYYY
Email*
Home Phone*
Work Phone
Cell Phone
Address*
Street Address Address Line 2 City State Zip Code
County*
Town/Township(s) you are located in
Farm Info
Farm Name
Size of Farm Operation

Commodities Produced

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Political Party
- Democrat
- Republican
- Independent
- Prefer Not To Answer
Signed Up by (Member Number)
Referred by
Comments or Requests

Subscription Auto Renewal*
By checking this box, I authorize Rhode Island Farm Bureau to annually charge my credit or debit card at the then-current annual membership dues rate. To discontinue auto-renewal billing, I understand that I must notify Rhode Island Farm Bureau by one of the below contact methods, at least one week prior to the auto-renewal billing date. The exact auto-renewal date will be provided in an annual reminder email. I understand refunds will not be issued after a payment has processed.
- Yes
- No

Full-Time Farmer Member 125
Price:
Part-Time Farmer Member 75
Price:
Friend of Farmer Member 35
Price:
Young Ag Professionals Member 35
Price:
Free
Price:
Your annual membership is only:
$0.00
Payment Method*
- Credit Card
- eCheck
Credit Card*

American Express
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MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
eCheck
Name on Account Bank Name Routing Number Account Number Account Type
Address*
Street Address Address Line 2 City State Zip Code
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Rhode Island Farm Bureau
16 Nooseneck Hill Rd

West Greenwich, RI 02817