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Nomination Form
CANDIDATE
*
First Name:
*
Last Name:
Street Address:
City:
State:
Zip:
Business Name:
Phone:
Industry leadership positions held (present):
Industry leadership positions held (past):
NOMINATOR (IF NOT A SELF-NOMINATION
Nominator First Name:
Nominator Last Name:
Affiliation:
Phone:
LIVESTOCK ACTIVITY
Please select those that apply to your operation
*
What is your/candidate annual
inventory maintained of beef cows?
please select one
None
Less than 100
101 to 500
Over 500
*
How many beef cattle
do you/candidate finish annually?
please select one
None
Less than 1,000
1,000 to 10,000
Over 10,000
*
How many cattle do you/candidate sell annually as
a stocker/grower, backgrounder, or pre-conditioner?
please select one
None
Less than 250
251 to 1,000
Over 1,000
*
What is your/candidate annual
inventory maintained of dairy cows?
please select one
None
Less than 200
Over 200
OPERATIONAL RESPONSIBILITIES
What is your/candidate primary
responsibility in the operations?
please select one
Owner
Manager
Foreman, Supervisor, Herdsman
Hired Hand/Employee
Other (please specify below)
Other:
(if "Other" is selected)
What is your/candidate occupation if not a beef producer/employee?
please select one
Nutritionist
Veterinarian
Extension/County Educator
Banker, Financial Institution
Packer, Processor
Livestock Market
Other (please specify below)
Other:
(if "Other" is selected)
Please type in 4 digital numbers:
