P.O. Box 5565
Washington DC 20016

NOMINATION FORM

There is no financial obligation in returning this form. 
You will receive additional information from the Nominating Committee.

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Name and Address
Organization name:
Address:
City:
State:
ZIP Code:
Country:
Telephone:
Fax:
E-mail:
Key Contact:
Key Contact's Title:

Expertise and Objectives
In what sector of the agro-industrial market are you most interested in expanding?
In which specific subjects is your organization able to lend expertise?
	Aquaculture/Fisheries		Feed/Seed
	Agchemicals/Fertilizers		Finance/Related Services
	Bakery/Grain		Food Distribution/Storage
	Beverages		Food Processing
	Biogenetic Engineering		Forestry
	Biomass/AgEnergy		Fruits/Vegetables
	Construction		General Groceries
	Dairy		Land Reclamation
	Equipment/Implements		Meat/Poultry
	Farm Management		Sweeteners
	Farm Product Marketing		Tobacco
Other:
Objective (reason for becoming a member of The Agribusiness Council):

The Agribusiness Council
P.O. Box 5565
Washington DC 20016

Tel: (202) 296-4563

info@agribusinesscouncil.org

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