FFA Membership Registration

Student Name (First & Last)

Student Age (on first day of school)

Current FFA Degree

Greenhand
Chapter
State
American

Year of FFA Membership (including this upcoming school year)

1
2
3
4
5

Amount of Dues Paid

$25.00
$15.00

Please enter an email address where you may be contacted

What committee would you like to join? (Please choose no more than 3)

Career Success (Student Division)
Healthy Lifestyle (Student Division)
Leadership (Student Division)
Personal Growth (Student Division)
Scholarship (Student Division)
Cooperation (Chapter Division)
Finance (Chapter Division)
Public Relations (Chapter Division)
Recruitment (Chapter Division)
Support Groups (Chapter Division)
Agriculture Promotion (Community Division)
Citizenship (Community Division)
Economic Development (Community Division)
Environmental (Community Division)
Human Resources (Community Division)

T-Shirt Size (included with $25 dues payment)

Small
Medium
Large
X Large
XX Large

Current Agriculture Class (Check all for which you are currently registered for the 15-16 school year))

Equine Science
Principles of Agriculture
Veterinary Science
Out of School Member (working toward American Degree)