Farmer - Landowner Match Application Form

Date:

Please provide the following contact information:

First Name
Last Name
Title
Farm Name
Home Phone
Work Phone
Cell
E-mail
website

Mailing Address: 

Farm Address (if different from above):

Which of the following categories best describe you? (select as many as apply):

Farmer                                           Landowner     

   Want to lease other's land                       Want  someone to lease owned land              
Interested in buying a farm                      Interested in selling a farm to stay as a farm  Other                                            

Farming Information:

Please describe your current experience with farming (rented land to farmer before, farmer yourself for x years, attended farm apprenticeship program, etc):

If you have a farm, describe your current operation, how you would utilize additional acres to be leased, your business plan if you have one, and how far from your home base you would be willing to lease additional land:

How many acres do you need?

Can your operation provide a landowner with an Agricultural Assessment?

Yes
No
Maybe

Details of Owned Land:

If you own land that you would like to rent out, please describe its current state (location, acres, condition, current use, land history) and how you would like it to be used if you can locate a farmer:

Infrastructure

Select any of the following options that apply:

Available on owned land   Desired on land to lease 

 water source              housing                 
fencing                  barns                     other                     

Farmland for Sale:

Are you interested in buying or selling land? If so, please describe what your are interested i either buying or selling (acres, water, location, views, etc.):

Information Release: 

I give Columbia Land Conservancy, Inc. permission to release my name, address phone number and any information provided in this questionnaire, including any maps of my property that the Conservancy may create,  to persons who in its judgment may match my farming interests.  I understand this in no way guarantees that I will be successfully matched.  In addition, I understand that the Columbia Land Conservancy is not responsible for any activities between participants resulting from our match-making  efforts.

Yes
No

Is there any other information you would like to share with us?