2012 Farm Family of the Year Plaque Order Form It is customary for the county committee to honor the farm family of the year with a plaque. In an effort to make the Arkansas Farm Family of the Year Program more uniform across the counties, the Arkansas Farm Bureau has acquired plaques in the shape of Arkansas that are approximately 10� x 13�. The plaques are available for $32.00. The plaques may be ordered in any quantity needed. If more than one organization desires to honor the farm family of the year with a plaque, please fill out a separate order form for each organization. Please allow 10 business days for processing and shipping. Please make all checks payable to the Arkansas Farm Bureau, and mail the check and order form to Andy Guffey, Arkansas Farm Bureau, P.O. Box 31, Little Rock, AR 72203.
County Name ____________________________________________________ Family Name (Please Print) _________________________________________ Presenting Organization (Please Print) _________________________________ Date Plaque Required ______________________________________________ Mail Plaque to: Name: __________________________________________________________ Street Address: ___________________________________________________ City and Zip: _____________________________________________________