Thank you for your decision to join the South Carolina Farm Bureau Federation on-line.
   
All you need to do to begin taking full advantage of our great member benefits is to
select the South Carolina County Farm Bureau Chapter you wish to join from the table
below, print this form, fill it out and mail it with your check or money order payable to:
   
SC Farm Bureau
On-Line Membership
PO Box 754
Columbia, SC 29202-0754

Name ____________________________________________________

Address __________________________________________________

_________________________________________________________

City _________________________________________Zip__________

Do you live in the city limits?    Yes    No

Date of Birth (mm/dd/yy) ______________________________________

Daytime Phone _____________________________________________

Evening/Weekend Phone _____________________________________

E-Mail ____________________________________________________

Fax Number _______________________________________________

County Chapter (See list below) _______________________________

Amount Enclosed   $ ________________________________________

Referred By ________________________________________________
   
 No, I do not derive a portion of my income from agriculture.
 Yes, I derive a portion of my income from agriculture.
(If yes, please complete all of the information below.)
   
Farming status:    Full time    Part time    Retired
   
Farming category:     Agricultural landowner
 Farm employee    Agribusiness    Other
   
Commodity Interests:
   
 Aquaculture    Cotton    Forestry    Fruit  
 Grain    Hay    Peanuts    Tobacco   Vegetables
   
HORTICULTURE:    Greenhouse    Nursery    Turf    Other
   
LIVESTOCK:    Beef    Swine    Horses    Dairy     Other
   
POULTRY:    Broilers    Layers    Turkeys    Other

Dues:

• Not refundable
• Not deductible as a charitable contribution and limited as a business expense for income
  tax purposes.

Membership entitles you to make application for services offered through the county,
state, and national organizations.