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Field Application Form

* Required Fields

Applicant Information
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Grower Information

Directions to farm:

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Crop Information
Previous Years

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FOR COTTON ONLY

Gin to be used:


Additional Comments
Terms

I understand and agree to abide by the Rules and Regulations of the MCIA relative to Certification of the crop listed above. Also, I confirm that the entire acreage listed above was planted with seed represented by tags and purchase invoice submitted with this application. I further understand that the Certification Committee may discontinue my membership if I am found guilty of violating the Rules and Regulations of the Association.

  
Additional Information

Note:

Applicant must provide adequate information for Inspector to identify fields and acres per field. FIELD INSPECTON FEES AND FINAL DATES FOR FILING APPLICATIONS

Contact Us

Phone: 662.325.3211

Fax: 662.325.8135

Email:
 
bkeith@mcia.msstate.edu
rita@mcia.msstate.edu

Mail:


 
MS Crop Improvement Assn.
P.O. Box MS
773 Stone Blvd.
Mississippi State, MS 39762

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