Become an MOA Representative

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If  you would like to become a Ministry of Agriculture (MOA) Representative, please complete the form below.

Your Name (required)

Your Email (required)

Your Phone # (required)

Your City (required)

Your State (required)

Mosque Phone #? (required)

Name of Mosque Secretary?

Have you signed Form 4? (required)
 Yes No

If so, when did you sign your Form 4? (required)

What city will your staple goods be sent to?

What skills and talents do you offer the MOA?

Which committees are you interested in?
 Buying Club
 Commodities
 Cooperative Corporation
 Credit Union/Banking
 Farming and Gardening
 Harvest
 Legal
 Membership/Promotions/Calendar
 Milk and Dairy
 News/Research/Communications
 Real-Estate
 Special Events
 Transportation and Logistics

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