Farmer Lease Application Form
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Gender
Male
Female
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How many years have you been living in the address stated above?
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Marital Status
Single
Married
Separated
Widowed
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Spousal Information
Name of Spouse
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
-
Month
-
Day
Year
Date
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Work/Employment and Education History
Start from current/latest down to the oldest
Work History
Education History
Agricultural Training (if not from formal education)
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Farming Activity
Are you currently involved in farming
Yes
No
Classification of your possession of the farm land
Owned
Leased
Communal Land
Homestead
Are you a member of an association?
Farmer's association
Producer's association
Cooperative
None
Other
Livestocks/Crops you own
Rice
Sugar Cane
Chicken
Swine
Cow
Goat
Geese
Duck
Other
Do you have or have you had any grants by the government
Please specify the kind of grant if yes
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Farm Plans
What you do plan to use the farm land for?
Grains
Vegetables
Vineyard
Tobacco
Rice
Sugarcane
Other
How many acres do you intend to lease
Interested in producing for
Own Consumption
Market Sale
Other
Will you be needing assistance for the following
Agricultural Training
Business Development plan
Business Registration
Market Access
Management Training
Other
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Applicant's Declaration
I hereby declare that I am the applicant stated in this form and hereby affirm that:
Applicant's Affirmation
I am of legal age;
The information I provided are true and correct to the best of my knowledge;
I understand that this application is not a contract and does not guarantee that a land will be allocated to me;
In the opportunity that I would be granted the lease, I will not use it for anything that is contrary to lawm public order, or public policy.
Name
First Name
Last Name
Signature
Date
-
Month
-
Day
Year
Date
Submit
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