Reallocate checkoff funds for SCCSA membership

Fill out this form completely to become a member of the South Carolina Corn and Soybean Association (SCCSA) using check-off dollars.

First name

Last name

Farm/Company name

Multi-line address

Country/Region

Address

City

Zip / Postal code

Phone

Membership Type

1 Year Membership = $20,000 of corn sold and checked-off in South Carolina within the past 12 months ($100 value)

3 Year Membership = $55,000 of corn sold and checked-off in South Carolina within the past 12 months ($275 value)

Form consent

By checking this box, I certify that I have sold, checked-off, and not previously refunded in South Carolina the above checked number of bushels of corn within 12 months of this date.