CT RC&D Climate Smart Agriculture Equipment Sharing Hub Application

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Account Registration

Company Name *

First Name *

The legal owner of the farm company.

Last Name *

Email *

Phone 1 *

Address Line 1 *

Address Line 2

City *

State/Province *

Zip/Postal Code *

Country

Mailing Address

If mailing address is different from above physical address, please include address in entirety here.

Contact Name

If different than the owner.

Contact Title and Affiliation

If different than the owner.

Type of Farm Operation *

Ex: Greenhouse, Nursery, Livestock, Dairy, Beef, Field Crops, Other

Years in Operation *

Are you a historically underserved producer? *

BIPOC

Veteran

New and beginning farmers (farming 1-3 years)

Anyone in a protected class

Anyone who speaks English as a second language

Other

No, I do not identify as a historically underserved producer

Please select which Equipment Sharing Hub you would like to participate in (please only select one):

CT Veteran Hub

Northeast CT Hub

CT River Valley Hub

Northwest CT Hub

Please attach the Equipment Hub Narrative document here. *

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