Contact Join Our Team Agricultural Workforce Training In-take Form This is the first step toward enrollment. You must complete this form in order to be considered for interview and the opportunity to participate in agricultural workforce program. Once the interview is completed you will be provided additional application/enrollment forms to fill out. Line Applicant Full Name * First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * Country (###) ### #### Date of Birth * Line Marital Status Single Married Widowed Divorced Spouses Full Name First Name Last Name Number of People in Household 1 2 3 4 5 6 7 8 9 10 10+ How Many Adults 1 2 3 4 5 6 7 8 9 10 How Many Children 1 2 3 4 5 6 7 8 9 10 Line Agricultural Workforce (select all areas of interest) Farmer Rancher Flexible Worker Farmer's Market Product Market/CSA Other Farming Experince describe your farming/ranching experience and types of products (vegetables, fruits, livestock, poultry and value added) you have produced/grown and sold in the past? How many years for each? List Farm Equipment Transportation (Do you own a vehicle) Yes No Supportive Services (select services needed) Housing Rent Assistance Transportation Assistance Child Care Assistance Work Clothes/Shoes assistance Relocation to Rural Community Assistance Agricultural Housing Ownership Other Thank you! Call or email us today. Name * First Name Last Name Email * Subject * Message * Thank you! EmailGeneral Inquiriesrtarlesson@thenesdac.org