CANDIDATE INTEREST FORM
For Nominating Committee or Board of Directors

Forms submitted will be shared with AgCountry's Nominating Committee.

To be eligible to serve as a Nominating Committee member, prospective candidates must meet the following requirements:

Own at least one share of AgCountry Class B Risk Stock and be the authorized voting stockholder or the authorized voting representative on record with AgCountry.
NOT a director, officer, employee or agent of any Farm Credit System institution.
NOT have served on the AgCountry Nominating Committee consecutively for the two previous years.
NOT, at the same time, be a candidate for a Director position.
NOT have an Association loan classified as Substandard, Doubtful or Loss Loan.

Important note: The Nominating Committee typically meets annually between February and May.

To be eligible to serve as a Director, prospective candidates must meet the following requirements:

Be involved in a farming operation and reside or farm within chartered territory of the Association.

Own at least one share of AgCountry Class B Risk Stock and be the authorized voting stockholder or the authorized voting representative on record with AgCountry.
NOT have an Association loan classified as Substandard, Doubtful or Loss Loan.
NOT a director, officer, employee or agent of any Farm Credit System institution (other than AgCountry) or FCA within the previous year from the election date.
NOT a director, officer, employee or agent for any other financial institution or entity that is authorized to offer the same type loans, leases or financially related services as AgCountry, including tax, farm accounting and records, insurance and succession and retirement planning.
NOT have attended a meeting as a member of the Nominating Committee in the same election cycle.

PROSPECTIVE CANDIDATE INFORMATION

Title

Legal First Name: *

Middle Name: *

Last Name: *

Date of Birth: * +

Preferred Name: *

Home Mailing Address: *

City: *

State: *

Zip: *

Home or Cell Phone: *

Email: *

County of Residence/Farming Operation: *

Are you currently designated as an AgCountry FCS voting stockholder? *

Yes

Desired candidacy (check one or both boxes): *

Nominating Committee

Board of Directors

Briefly describe your agricultural business or operation: *

Describe your educational background including schools you attended, degrees earned, majors studied, certifications, etc.: *

Job and Occupational Experience – Provide any relevant career experiences or special skills/abilities you would bring as a candidate: *

Provide an example of a leadership role you have held and how that has prepared you for a position on the AgCountry Board of Directors: *

Identify other strengths you may have related to the AgCountry Director position: *

Is your schedule flexible enough to allow you to attend AgCountry Board Meetings and other required events? (Generally 25 to 35 days per year, including regular board meetings (1 or 2 days toward the end of the month), plus several planning and training sessions throughout the year.) *

Yes

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