2023 Young Leaders in Agriculture Conference Registration Form

Name*

First Last

The information listed should be the attendee's information.

Email*

Cell Phone*

Current Mailing Address*

Street Address Address Line 2 City State ZIP Code

Attendees address*

College*

Year in College for Fall 2023*

College Major*

Employer or Organization You Represent*

Resume Upload*

Max. file size: 256 MB.

Please upload a copy of your up-to-date resume. This will inform aspects of the event.

What Agriculture Commodities Are You Involved With? Select All That Apply*

Please rank the following topics from first choice to fifth choice – most desired (first) to least desired (fifth) – based on your desire to be part of the team that works on each issue.

Case Study Topic - First Choice*

Case Study Topic - Second Choice*

Case Study Topic - Third Choice*

Case Study Topic - Fourth Choice*

Case Study Topic - Fifth Choice*

Gender*

Responses will be used in rooming assignments.

Rooming Preference*

Roommate
Single

To assist with managing our budget, if you are comfortable having a roommate, we appreciate you including that preference.

Preferred Roommate*

* No guarantee

Please indicate below any special dietary requirements or accommodations you need.

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2023 Young Leaders in Agriculture Conference Registration Form

Young Leaders in Ag Conference Registration 2023