National Agriculture Apprentice Learning Network (AgALN) - TA Intake Survey
Please fill out this form with as much information as possible about your project and organization, and a staff person will contact you about how our program can support your work. We look forward to hearing from you.
First Name
Last Name
Title
Organization Name
Street
City
State/Province
Zip/Postal Code
Billing Country
Preferred Phone #
Preferred Email
Website
Offers Beginning Farmer Services?
Description of Apprentice/Beginning Farmer Services
Organization Type (select all that apply using ctrl)
Please select...
Farm
Farm Service Provider
Non-Profit
Government Agency
University
Private Business
Vendor
Natl TA Provider
Natl TA Recipient
Funder
Media
Apprentice Project Type
Please select...
Has Apprentice Site
Potential Apprentice Site
Model w/o Apprentice Site
University training w/ land based education
Stage of operation
Please select...
Very early stages (not yet in operation)
In operation 0 - 1 years
In operation 2 - 4 years
In operation 5 - 9 years
In operation 10+ years
Land Tenure Arrangement (select all that apply using ctrl)
Please select...
Lease
Own
State
Community
Number of apprentices you work with on yearly basis
Apprentice Population category
Please select...
US Born
Refugee
Immigrant
Low-income
College student
Population details (specific countries of origin, etc.)
College credit available
What are your specific program goals?
What topic areas/challenges are you seeking TA support for?
How did you find out about AgALN?
What else could the network be doing to support your program?
Contact Information