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* 1. Your Name (Listed SRIs only please)

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* 2. Your Farm Name

You may complete this form at any time of year, once you have completed at least three Qualified inspections within a fourteen month window. Qualified inspections may be either remote or in person. 
- 3 Qualified Inspections -> $100 dues waiver
- 4 Qualified Inspections -> $150 dues waiver (full coverage of minimum required dues)
You will receive an email confirming your dues waiver once this form is reviewed. 

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* 3. Inspection Conducted #1

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* 4. Inspection Conducted #2

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* 5. Inspection Conducted #3

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* 6. Inspection Conducted #4 (optional)

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* 7. How many months passed between the earliest inspection listed and the most recent inspection?

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* 8. Today's date

Date

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* 9. Use this space to share anything else you'd like us to know. Thank you for participating in this important new initiative!

0 of 9 answered
 

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