Step 1 of 5 20% I am...Please select your membership type below.*A Farmer / Part-time FarmerAn Agri-BusinessA Non-FarmerA MDFB EmployeeA StudentAre you an insurance agent, or are you working with an insurance agent?*YesNoInsurance InformationGet ready to save! Please enter your insurance agent's information here.Agent Name*Agent Number*Agent Email Agent Phone Number Contact InfoMembership Number* First Name Last Name Birthdate Birthdate* Spouse's NameSpouse's Birthdate Email County*- Select -AlleganyAnne ArundelBaltimoreCalvertCarolineCarrollCecilCharlesDorchesterFrederickGarrettHarfordHowardKentMontgomeryPrince George'sQueen Anne'sSt. Mary'sSomersetTalbotWashingtonWicomicoWorcesterHome PhoneWork PhoneCell PhoneAddress* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Zip Code Township(s) you are located in Farm InfoFarm NameSize of Farm Operation- Select -SmallMid-SizeLargeCommodities Produced Dairy Fruit Grains Hay Horses Livestock Poultry Vegetables Other Political PartyDemocratRepublicanIndependentSigned Up byReferred byComments or Requests Subscription Auto Renewal*By checking this box, I authorize Maryland Farm Bureau to annually charge my credit or debit card at the then-current annual membership dues rate. To discontinue auto-renewal billing, I understand that I must notify Maryland Farm Bureau by one of the below contact methods, at least one week prior to the auto-renewal billing date. The exact auto-renewal date will be provided in an annual reminder email. I understand refunds will not be issued after a payment has processed.YesNo Renewal Anne Arundel Price: $55.00 Renewal Baltimore Price: $60.00 Renewal Caroline Price: $60.00 Renewal Garrett Price: $60.00 Renewal Harford Price: $60.00 Renewal Montgomery Price: $65.00 Renewal Somerset Price: $65.00 Renewal Wicomico Price: $65.00 Renewal Worcester Price: $65.00 Renewal Allegany Price: $70.00 Renewal Carrol Price: $70.00 Renewal Cecil Price: $70.00 Renewal Charles Price: $70.00 Renewal Dorchester Price: $70.00 Renewal Frederick Price: $70.00 Renewal Kent Price: $70.00 Renewal Prince George's Price: $70.00 Renewal Queen Anne's Price: $70.00 Renewal St. Mary's Price: $70.00 Renewal Washington Price: $70.00 Renewal Calvert Price: $75.00 Renewal Talbot Price: $75.00 Renewal Howard Price: $80.00 Renewal Student Price: $21.00 Your annual membership is only: $0.00 Credit Card* American ExpressDiscoverMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Security Code Cardholder Name Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Zip Code This iframe contains the logic required to handle Ajax powered Gravity Forms. Maryland Farm Bureau will not issue refunds. Privacy Policy | Terms & Conditions
