STATE NOMINATION FORM SWISHER SWEETS/SUNBELT EXPO SOUTHEASTERN FARMER OF THE YEAR

Transcription

1 STATE NOMINATION FORM SWISHER SWEETS/SUNBELT EXPO SOUTHEASTERN FARMER OF THE YEAR NOTES: A. Return Form to Nominator s Office B. Must Be Signed By All Parties Listed Below (areas to sign are highlighted in red) C. To fill out form, click gray text boxes and they will turn black. Enter data and do NOT tab. 1. Name Age 2. Address City, State, Zip,, 3. Home Phone ( ) - Business Phone ( ) - Cell Phone ( ) - 4. Name of Spouse (if married) 5. Children Age Children Children Children Age Age Age 6. Social Security Number Local Newspaper Local TV Station Name of Paper Only Call Letters Only We certify the information on the attached application and entry forms is an accurate and true statement to the best of our knowledge. Applicant s Signature Date Spouse s Signature Nominator s Name Nominator s Signature Date Nominator s Address City, State, Zip,, Nominator s Phone ( ) - Cell Phone ( ) - I hereby certify the above applicant is the swisher Sweets/Sunbelt Expo Farmer of the for: Name of State Date State Coordinator s Signature State Coordinator s Address City, State, Zip,, State Coordinator s Phone ( ) - Cell Phone ( ) -

2 Note: This application should reflect your operations during the immediate past tax accounting year so as to ensure standardization of information from all applications. I. FARMING STATUS A. Owner Rental Combination B. Independent Operator Partnership Corporation C. Total acres operated first year of farming Acres Rented Acres Owned D. Total acres currently operated Acres Rented Acres Owned E. Number of years farming or ranching II. FARMING PROGRAM A. List Major Crops * No. of Acres Yield per Acre *Indicate if irrigated

3 III. LIST MAJOR LIVESTOCK / OTHER ENTERPRISES. (Under production units indicate number of head, pounds, dozen, or other appropriate measure of volume.) A. Enterprise Production Units B. Describe briefly how you market your crops and/or livestock enterprises. C. List other farm or related business enterprises and describe size and relate importance to your total operation. D. LEADERSHIP EXPERIENCE AND COMMUNITY SERVICE Note: This applies to you and your spouse, if married. A. List leadership roles and community service you and your spouse have fulfilled at the local, state, and national levels (include participation in various organizations and activities church, schools, youth groups, civic, fraternal, governmental, agricultural, etc.) Applicant: County Level Activities

4 State Level Activities National Level Activities SPOUSE: County Level Activities

5 State Level Activities National Level Activities IV. APPLICANT S FINANCIAL STATEMENT A. Current Value of only your share You Started Farm Full Time of: (1) Value of land $ $ Current (2) Value of buildings & improvements $ $ (3) Value of machinery & equipment $ $ (4) Value of livestock & poultry $ $ (5) Value of crops & supplies on hand $ $ (6)Value of other assets $ $ Non-farm real estate $ $ Cash, stocks, bonds, cash value of Life insurance, other personal assets $ $ Total $ $ Minus total indebtedness $ $ Current Net Worth $ $

6 V. EVIDENCE OF SOUND MANAGEMENT PRACTICES A. List your goals and degree of accomplishments in improving the quality of the farming program. Goals: Achievements Gained: B. Indicate major problems connected with your operations which you have overcome or solved since you started farming.

7 C. Indicate plans of development for future expansion, for improvements or changes in your farming operation. D. Describe briefly how you started farming.

8 E. Write a short paragraph about special practices you have employed that contribute to protecting the environment. F. A brief statement about the activities and projects in which your children or other members of your family are involved are welcomed.