GROWER REGISTRATION FORM

DATE: …………………….

NAME: ………………………………………………………………………………………………….

ID NO: ……………………………………

P. O. Box: …………………………………. PHONE NO: …………………………………………….

EMAIL ADDRESS: …………………………………………………………………………………………………………………

COUNTY ……………………………………………… SUB-COUNTY………………………………………………………….

LOCATION………………………………………. SUB-LOCATION…………………………………………………………

Here below are the details of my avocado farming

FILLED BY APPLICANT
Location of land
Hass trees currently in production
Hass trees in need of planting
Fuerte trees in production
Fuerte trees in need of planting
Other avocado trees on farm
Total acreas of land on production

Name: …………………………………………………………

Signature: ………………………………….

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OFFICAIL USE ONLY

Name of Officer …………………………………………………………

Signature: ………………………………