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2.) Contest
Registration Form
a)
Last Name
b)
First Name
c)
Home Address
i.
Home City
ii.
Home County
iii.
Home State
iv.
Home Zip
v.
Home Phone
vi.
Mobile Phone
vii.
Email
d)
Farm Name
e)
Farm Address (if different from home address)
i.
Farm City
ii.
Farm County
iii.
Farm State
iv.
Farm Zip
v.
Farm Phone
f)
Your Age
i.
18-24
ii.
25-49
iii.
50-65
iv.
65+
g)
Total Tillable Acres Farmed
h)
Tillable Acres By Crop (planned for 2007)
i.
Soybeans
ii.
Corn
iii.
Wheat
iv.
Cotton
v.
Sorghum
vi.
Barley
vii.
Oats
viii.
Rice
ix.
Sunflower
x.
Canola
xi.
Dry Edible Beans
xii.
Potatoes
xiii.
Sugar Beets
xiv.
Other (describe)
i)
Tell us about the farm equipment you own or
operate (include brand name and series). [essay answer box]
j)
Are you currently using a precision ag system
on your farm?
i.
No.
ii.
Yes
(If yes, please
describe the equipment you are using). [essay answer box]
k)
Why are you interested in using a precision ag
system on your farm? [essay answer box]
l)
Tell us about some of the challenges you face
on your farm. [essay answer box]
m)
Name and location of the nearest John Deere dealer:
(You DO NOT need to be a current John Deere customer to participate
in this program.)
i.
Name
ii.
City
iii.
State
n)
Tell us why you should be selected to use a premium
level John Deere precision ag system on your farm for the entire
2007 U.S. growing season. [essay answer box]
o)
I have read the contest rules, and if selected for
this program (check all that apply):
i.
I agree to participate in two (2) online
surveys during the 2007 season to provide feedback about my
experiences with this new technology.
ii.
I understand that completion of two online
surveys is required if I am to be offered an opportunity to purchase
the entire system, or just the components I want to own, at a
greatly reduced price at the end of the program, or December 31,
2007, whichever comes first.
iii.
I agree to participate in one regional grower
education meeting if one is offered near my home during either July
2007 or January 2008.
iv.
I grant permission for the American Soybean
Association and/or John Deere to utilize my online survey answers
for educational purposes designed to encourage adoption of precision
ag management tools.
v.
I grant permission for the American Soybean
Association, John Deere, and local John Deere dealer to utilize my
name, farm location, likeness, and/or recorded testimonials for
news, promotion and/or advertising purposes without further
compensation. |
