2026 Georgia Farm Bureau Ag Tech Committee Application Form

2026 Ag Technology Committee Application

Please submit by Friday, January 23, 2026

Please fill out the following application:

Please do not type in all uppercase letters.

Title*

Mr.
Mrs.
Ms.
Miss.
Dr.

Applicant's Name*

Applicant's Email*

Confirm Applicant's Email*

Applicant's Mobile #*

Address*

County*

District*

Farm Bureau Membership Number*

Do you currently serve on a GFB CAC?*

Yes
No

Please rate your interest in agricultural technology. The scale runs 1-10. 1 being no interest and 10 being very interested.*

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Please rate your level of experience in agricultural technology. The scale runs 1-10. 1 being no experience and 10 being very experienced/ comfortable with the subject.*

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Provide a brief description of your farming operation or career background and experience with agricultural technology. Please elaborate how agricultural technology is utilized in your operation.*

Provide a brief description of how new and emerging technology could be implemented or utilized in your farm operation.*

Provide a brief description of your involvement in Farm Bureau and the agricultural community, including leadership roles, awards. research, academia, etc.

Please contact Raynor Churchwell ([email protected]) with questions.

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