Print the application form below and mail to the California Farm Bureau
Federation Help Desk, 2300 River Plaza Drive, Sacramento, CA 95833. We
will contact you to verify the dues rate for your county Farm Bureau and
will then send you an invoice.

Name: __________________________________________________________

Home Address: ___________________________________________________

City: _______________________________ State: _________Zip: __________

Business Address: ________________________________________________

City: _______________________________ State: _________Zip: __________

Home Telephone Number: ___________________________________________

Business Telephone Number: _________________________________________

Fax Number: _____________________________________________________

E-mail Address: ____________________________________________________

(Please check one)
I would like to join as:
Individual     Corporation     Partnership
Only individual members receive the Accidental Death and Dismemberment
Policy as a part of their membership.

(Please check one)
I would like to receive my mail at the:
Home address
Business address

To determine your level of membership, please select yes or no in
response to the following statement:
I now receive income or expect to receive income within the next year
from actual farming and ranching activities.
Yes     No

Please check preferences for us to contact you:
E-mail     Telephone     Mail