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 ArkansasFarm Family of the Year Program more uniform across the counties, the ArkansasFarm Bureau has acquired plaques in the shape of Arkansasthat 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, pleasefill out a separate order form for each organization. Please allow 10 business days for processing and shipping. Pleasemake all checks payable to the ArkansasFarm Bureau, and mail the check and order form to Andy Guffey, ArkansasFarm Bureau, P.O.Box 31, Little Rock, AR 72203.
County Name ____________________________________________________ Family Name (PleasePrint) _________________________________________ Presenting Organization (PleasePrint) _________________________________ Date Plaque Required ______________________________________________ Mail Plaque to: Name: __________________________________________________________ Street Address: ___________________________________________________ City and Zip: _____________________________________________________