1312 Eighteenth Street, N.W., Suite 300
Washington, D.C., 20036

NOMINATION FORM

There is no financial obligation in returning this form. 
You will receive additional information from the Nominating Committee.

Name and Address
Organization name:
Address:
City:
State:
ZIP Code:
Country:
Telephone:
Fax:
E-mail:
Key Contact:
Key Contact's Title:

Expertise and Objectives
In what sector of the agro-industrial market are you most interested in expanding?
In which specific subjects is your organization able to lend expertise?
	Aquaculture/Fisheries		Feed/Seed
	Agchemicals/Fertilizers		Finance/Related Services
	Bakery/Grain		Food Distribution/Storage
	Beverages		Food Processing
	Biogenetic Engineering		Forestry
	Biomass/AgEnergy		Fruits/Vegetables
	Construction		General Groceries
	Dairy		Land Reclamation
	Equipment/Implements		Meat/Poultry
	Farm Management		Sweeteners
	Farm Product Marketing		Tobacco
Other:
Objective (reason for becoming a member of The Agribusiness Council):

The Agribusiness Council
1312 Eighteenth Street, N.W., Suite 300
Washington, D.C., 20036

Fax: (202) 887-9178

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