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Potato Grower magazine
Qualification Survey

Potato Grower
Qualification Form and Questions
Contact Name:   
Company:   
Address:   
City:   
State:   
Zip:   
Phone:   
E-Mail:   
Grower Qualification Questions
Do you receive the Potato Grower Magazine?    YES   OR    NO
Would you like to receive our Potato Grower Magazine?    YES   OR    NO
Do you still grow potatoes?    YES   OR    NO
Acres in potatoes?   
Other crops in rotation, such as:
Sugar Beet acres:   
Barley acres: 
Wheat acres:    
Hay acres:    
Other: Crop:     Acres:    
How many years have you been growing?
How many years do you plan to farm until you retire?
Will the farm be passed on to a family member? YES   OR    NO
Will you sell it? YES   OR    NO
Will you lease it? YES   OR    NO
Other:
Other Farm Managers or decision makers that should be receiving
Potato Grower Magazine (name and addresses):
Thank You for your time!
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© 2013 Potato Grower® Magazine Published by Harris Publishing, Inc.