Become a Member: I Have Sold Corn in North Dakota

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"I Have Sold Corn in North Dakota" Membership Application

All fields marked with an * are required.

Name *

Farm/Business Name

Address *

City *

State *

Zip *

County *

Home Phone *

Mobile Phone *

Email *

Spouse Name

Recruiter Name

Membership Type *

New Membership

Renewal

Membership Payment *

I have sold at least 12,000 bushels of corn in North Dakota entitling me to a free 1-year membership.

I have sold at least 24,000 bushels of corn in North Dakota entitling me to a free 3-year membership.

Electronic Signature

By signing below, I certify that I have sold the above numbers of bushels of corn in North Dakota within one year of this date. I authorize and assign payment of the above bushels sold for a membership in the North Dakota Corn Growers Association.

Signature (Type Your Name) *

Date *

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