Name *

First Name

Last Name

I will continue to serve on the Advisory Committee in 2019 *

Yes

No

Will you be attending the meeting? *

Yes, in person.

Yes, by phone.

No, my regrets.

I am willing to work on the following subcommittee through 2019 (four meetings per year)

Flagship Farm / Innovators Program

Pesticide Education

Bee Protection Protocols

I am not willing to do subcommittee work