Pre-Convergence Survey 2019 Question Title * 1. First Name Question Title * 2. Last Name Question Title * 3. Email Address Question Title * 4. Phone Number Question Title * 5. Street Question Title * 6. City Question Title * 7. State Question Title * 8. Zip Code Question Title * 9. Farm/Organization Name Question Title * 10. What do you farm? You can select multiple answers. Vegetables Livestock Grains Field Crops Dairy Flowers Other (please specify) Question Title * 11. Number of years farming Question Title * 12. Position on farm Farm Owner Farm Manager Farm Employee Farm Apprentice Other (please specify) Question Title * 13. Do you actively engage in other leadership roles in your community or at the state or federal level (i.e. member of Conservation District Board, appointee to state advisory board, etc)? If so, please list all that apply. Question Title * 14. Please tell us your Instagram handle, if you have one. Question Title * 15. Please tell us your Twitter handle, if you have one. Question Title * 16. Would you like to be tagged in our Convergence social media postings? Yes No Next