Indiana Farm Bureau

2010 Young Farmer Leadership Conference Registration

January 29-31 at the Indianapolis Marriott East Hotel.

Choose only one option:

$100 registration fee, includes 1 night stay in hotel
$160 registration fee, includes 2 night stay in hotel
No room needed

Send NO money now. If you are a current member of Indiana Farm Bureau, your registration fee will be billed to your county office after the conference.

* Full Name:
* Address:
* City:
* State:
* Zip Code:
* County:
* Cell Phone:
* Rooming With:
Number & Ages of Children Attending :
King or Double Bed
*Arrival Date:
*Departure Date:
*Email Address:
*Membership number: