. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

NORTHEAST COUNTIES FARM BUREAU DIRECT SALE PRODUCT DIRECTORY QUESTIONNAIRE

Name (Individual)

Name (Farm/Business)

Address

Phone Number(s)

Email Address

Website

Products you sell direct

Hours

Please indicate size and price
of advertisement needed.

BUYER'S BENEFIT BOOK QUESTIONNAIRE

Listing Information (if different from above)

Discount or Coupon Offer.

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Your listings will be FREE with your paid Farm Bureau active membership. Please fill out this form by July 30, 2010. You may also submit a printed form to the Farm Bureau office at 53-B E Main Street, Orwell, Ohio, 44076.