KEMI Alumni Membership Application

Please fill out this form exactly as you would like your member listing to appear in the KTFMC Directory. If there is a required item you do not want to appear in your listing or to add something that cannot be included in this form, please include a description in the notes area.
Name:*
E-mail:*
Member Type:*
Farm:
Job Title:
Address:*
Business Phone:
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Home Phone:
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Cell Phone:
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Notes: