AgArts Collective Registration

Please Fill out this Form to Register your Collective

Names and contact information of three core people in the collective:
Name 1*
First Last
Address 1*
Street Address Address Line 2 City State ZIP Code
Phone 1*
Email 1*
Name 2*
First Last
Address 2*
Street Address Address Line 2 City State ZIP Code
Phone 2*
Email 2*
Name 3*
First Last
Address 3*
Street Address Address Line 2 City State ZIP Code
Phone 3*
Email 3*
Group Details:
Location of Group*
City State
Description of your Collective and its Goals (1,500 characters max.)*
Plans to Achieve your Goals (1,500 characters max.)*