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Membership Form

First Name *

Last Name *

Email *

Phone

Password *

Eight characters minimum One lowercase letter One uppercase letter One number One special character

Choose a password so you can access your account for custom content and to maintain your membership.

Gender *

Male

Female

Prefer Not to Say

Date of Birth

Country of Origin *

Current Location *

Please include City, Province, Country

Type of Farming you are interested in *

Livestock Farming

Vegetable Farming

Both Types of Farming

Tell us a little about yourself *

Background, interests, goals etc.

How long have you been farming and why are you interested in farming in Canada?

Declaration *

I hereby declare that I voluntarily opted to be part of the Canadian Black Farmers Association. I consent to the release of my personal data for the use of The Canadian Black Farmers Association to inform their programs and community advocacy. Your personal data will not be released to any other person, organization or entity unless to better serve Canadian Black Farmers Association programming and community advocacy.

I understand that I will be added to the Canadian Black Farmers Association email list. I can unsubscribe at any time after receiving my first email correspondence.

I agree to be charged an annual membership fee of CAD $100.00, and I understand that this fee is non-refundable for any reason..

Please check all boxes above to complete your consent declaration.

Renewal Information

New Expiry Date

We will automatically send you an email reminder in advance of your expiry date so you can renew next year. If you have questions about your membership, please contact us.

Payment

Payment *

Billing Address *

Billing Address

City

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Zip/Postal

Country

Billing Address

Administration

Original Submission Date

Expiry Date

Membership Approved

Yes

Date Approved

Payment Received

Yes

Used for International and eTransfer Payments. This will be automatically set when paying by Credit Card.

Date Received

This will be automatically set when paying by Credit Card.

Payment Status

Notes

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Canadian Black Farmers Association

The Canadian Black Farmers Association is a non-profit organization on a mission to break down barriers and empower Black Canadians to thrive in the agricultural sector.

Email: info@canadianblackfarmers.ca

We gratefully acknowledge the support received from the following:

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