Request a Free Sticker
Name
*
First
Last
Farm Name
Address
*
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone
E-mail
Enter Email
Confirm Email
County
*
Androscoggin
Aroostook
Cumberland
Franklin
Hancock
Kennebec
Knox
Lincoln
Oxford
Penobscot
Piscataquis
Sagadahoc
Somerset
Waldo
Washington
York
Check the stickers you want to receive.
Work Safely: Keep Farming
Work Safely: Keep Fishing
Work Safely: Keep Logging
Farm Strong
Gasoline Only
Diesel Only
Number of Work Safely: Keep Farming stickers you want to receive:
*
(5 Maximum)
1
2
3
4
5
Number of Work Safely: Keep Fishing stickers you want to receive:
*
(5 Maximum)
1
2
3
4
5
Number of Work Safely: Keep Logging stickers you want to receive:
*
(5 Maximum)
1
2
3
4
5
Number of Farm Strong stickers you want to receive:
*
(5 Maximum)
1
2
3
4
5
Number of Gasoline Only stickers you want to receive:
*
(5 Maximum)
1
2
3
4
5
Number of Diesel Only stickers you want to receive:
*
(5 Maximum)
1
2
3
4
5
Number of working tractors
Number of different tractor operators
Farm Activities
Check all that apply.
agribusiness
dairy
field/grain crops
fruit/vegetable crops
hay
livestock
nursery crops
orchard crops
poultry
specialized crops
other
If other, please describe:
Email
This field is for validation purposes and should be left unchanged.
Visit Page
Request a Free Sticker