Membership Application
Date: ______________________
Farm Name: ______________________________________________________________
Address: ______________________________________________________________
______________________________________________________________
______________________________________________________________
Phone Numbers: ______________________________________________________________
Email: ______________________________________________________________
Website: ______________________________________________________________
Owners: ______________________________________________________________
______________________________________________________________
_______________________________________________________________
Please briefly describe your Agritourism Business:
Annual Dues are $25.00 per farm. Please make check payable to
Mississippi Agritourism Association and mail to: Charlotte Adkins: