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What is your primary business activity.*

1. Retailers/Dealers and Distributors and Custom Applicators of Crop Inputs (please check all activities that apply)

M. Ground Application	R. Air Application
Q. Precision Ag Services	A. Grain Marketing
X. Seeds	P. Custom Planting
G. Pesticides	H. Custom Harvesting
D. Fertilizers

3. Fertilizer Producer of Primary, Secondary and Micro Nutrients

4. Pesticide and Related Chemicals
B. Manufacturer
C. Formulator

5. Equipment and Component Parts Manufacturer and/or Distributor/Dealer

6. Advisory and Technical Operations

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Title: (please check only one)

	A. Corporate/Executive Management
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	C. General/Location Manager
	D. Sales Representative
	E. Technical/Consulting Manager
	F. Precision Ag/Information Services Management
	Z. Other (please specify)

Please indicate you total sales of crop protection, fertilizer, seed, and services for this year.

	1. $2 million or less
	2. $2,000,001 - $5 million
	3. $5,000,001 to $10 million
	4. $10,000,001 to $15 million
	5. $15,000,001 to $25 million
	6. $25,000,001 to $50 million
	7. $50,000,001 to $100 million
	8. more than $100 million

Application Customers
1. Over 200 2. 100-199 3. 50-99 4. Under 50

Acres Custom Applied

1. Over 75,000	4. 10,000-24,999
2. 50,000-74,999	5. Under 10,000
3. 25,000-49,999

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