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First name
Last name
Phone number
Your email
Business Name (If applicable)
City, State
What services do you provide?
What is your average or requested cotton order quantity?
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Land Address
Land City, State
Land Acres
Has your land been farmed on in the last 1-3 years? YesNo
If so, what crops?
Does your land border any farms? YesNo
Are you interested in farming your land? Manage my own farmJoin, partner and allow B.L.A.C.Kollective to grow on land
Do you have any experience with cotton or farming? YesNo
What experience do you have with cotton/farming? (optional)
Farm name (If applicable)
Farm Address
Farm City, State
Farm Acres
Are you currently using any climate-beneficial practices? This is not required; practices include: composting/cover crops/companion crops/ no-till or strip-till/ water harvesting/etc. YesNo
What crops are you currently growing?
Do you have any experience with cotton? YesNo
What experience do you have with cotton? (optional)
Farm name
Number of farmers (Farm Orgs/Co-ops Only)
Are you currently using any climate-beneficial practices? This is not required; practices include: composting/cover crops/companion crops/ no-till or strip-till/ water harvesting/etc. (optional) YesNo
What are you currently growing? (optional)
Do you understand this program? YesNo
Questions? (optional)
What cotton variety/s do you grow?
How many acres of cotton are you growing?
Are you growing any other crops? YesNo
What other crops are you currently growing?
