Registration - 2025

First Name *

Last Name *

Street Address *

Address Line 2

City *

Zip Code *

Email Address *

Phone Number for Day-Of Event Contact *

Select your county or collegiate program. *

Are you a current Wisconsin Farm Bureau Member? * 🛈

Yes

No

Do you serve as the county Promotion & Education or Women's Committee Chair? *

Yes

No

How did you hear about the event? If an individual referred you, please list their name:

Select a registration option: *

Saturday Only ($80)

Friday Pre-Conference Activity and Saturday ($100)

Please select a meal option for the Friday pre-conference event. *Sandwiches served with a side of Kettle Chips. *

Original Grilled Cheese (Cheddar)

Two Brothers (Havarti and Muenster)

Triple Cheese (Cheddar, Havarti, and Muenster)

Ham and Havarti Cheese

Chicken, Bacon, Ranch with Muenster Cheese

Farmhouse Salad with Grilled Chicken

Select a beverage for the Friday meal: *

2% White Milk

Chocolate Milk

Bottled Water

List any dietary restrictions, if applicable.

Provide any other information about your registration the event planners should be aware of, if applicable:

Select a payment option. *

Online with a credit card

Mailing in a check

Invoice my county Farm Bureau

Name as it appears on credit card: * 🛈

County or Collegiate Program to Invoice: *

No refunds will be issued for registrations cancelled on or after February 1, 2025. *

I agree to the cancellation policy.

If paying by check, please send payment now to:
Wisconsin Farm Bureau Foundation
Attn: Cultivate & Connect
PO Box 5550
Madison, WI 53705

If paying by credit card, please be prepared to enter card information on the next page.

You will receive a copy of your registration via email upon submission.