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We want to register as many past FFA members and friends as possible.
Can we add you to our list?

We'd like to keep you up to date on FFA events, FFA Foundation activities and our fundraising successes. Please take a moment to share your contact information with us—and we'll make sure you keep in touch with the Nebraska FFA Foundation.

(Bolded fields are required.)

First Name:

Last Name:

Middle Initial

Maiden Name:

Gender:

Male Female

Address:

Address 2:

City:

State:

Zip Code:

Daytime Phone:

E-Mail:

Confirm E-Mail:

High School Graduation:

I am:
(Mark all that apply)

A Past FFA Member
Chapter
Parent of an FFA Member
Former FFA Advisor
Current FFA Advisor
FFA Supporter
Other:

Referred By:

I am interested in information on the following:

Ted Ward Legacy Fund
Nebraska FFA Jacket Fund
Event/Program Sponsorship
General Program Support
FFA Foundation Newsletter
Other:

My favorite "True Blue" Memory:

We are also interested in knowing what you were involved in, when you were in FFA. Below is a listing of programs and activities to check that apply to you:

Highest FFA Degree Earned:

American FFA/American Farmer Degree
State FFA/State Farmer Degree
Chapter FFA/Chapter Farmer Degree
Greenhand Degree

Highest FFA Office Held:

National Officer
State Officer
Local Chapter Officer

AWARDS & ACHIEVEMENTS

Major Awards Received

Agriscience Award: Agri-Entrepreneurship Award: Risk Management Essay Contest:
Star Program: (Mark all that apply)
	State Star in Agribusiness Finalist or State Winner State Star in Agriscience Finalist or State Winner State Star in Placement Finalist or State Winner State Star in Production Finalist or State Winner American Star Farmer Finalist or National Winner American Star in Agribusiness Finalist or National Winner American Star in Agricultural Placement or National Winner American Star in Agriscience or National Winner
Proficiency Award Program: (Mark all that apply)
	Agricultural Communications Agricultural Education Agricultural Mechanics Design and Fabrication Agricultural Mechanics Energy Systems Agricultural Mechanics Repair and Maintenance Agricultural Processing Agricultural Sales Agricultural Services Aquaculture Beef Production Dairy Production Diversified Agricultural Production Diversified Crop Production Diversified Horticulture Diversified Livestock Production Emerging Agricultural Technology Environmental Science and Natural Resources Management Equine Science Fiber and/or Oil Crop Production Floriculture Food Science and Technology Forage Production Forest Management and Products Fruit Production Grain Production Home and/or Community Development Landscape Management Nursery Operations Outdoor Recreation Poultry Production Sheep Production Small Animal Production and Care Specialty Animal Production Specialty Crop Production Swine Production Turf Grass Management Vegetable Production Wildlife Production and Management Other:
Leadership Skills Events: (Mark all that apply)
	Agricultural Demonstration Ag Technology Cooperative Speaking Creed Speaking Extemporaneous Speaking Job Interview Jr. Parliamentary Procedure Jr. Public Speaking Natural Resources Speaking Quiz Bowl Jr. High Sr. Parliamentary Procedure Sr. Public Speaking Other:
Career Development Events/Contests: (Mark all that apply)
	Agricultural Communications Agricultural Issues Agricultural Mechanics Agricultural Sales AgriScience Agronomy Equine Evaluation Farm Business Management Floriculture Food Science Livestock Management Jr. Livestock Judging Sr. Livestock Judging Marketing Plan Meats Evaluation and Identification Natural Resources Nursery and Landscape Welding Other:
Attended or Participated In: (Mark all that apply)
	State FFA Convention National FFA Convention Washington Leadership Conference (WLC)/Washington Conference Program (WCP) Chapter Officer Leadership Training (COLT) Conference Pursuing Excellence, Achievement and Knowledge (PEAK) Conference/Young Member Conference State FFA Band National FFA Band State FFA Chorus National FFA Chorus National FFA Talent Other:

THANK YOU FOR SHARING - BUT WE WON'T! We will not share your mailing address, e-mail address, or phone number at any time. If you share an FFA memory, you are authorizing us to use it on this Web site and in other marketing materials. Please be advised that we reserve the right to edit as appropriate - and will do as needed, without materially altering the content or intent of your story.