Agriculture Safety Day Scholarship / Beca del Día de la Seguridad Agrícola Name/Nombre First Last Address/DIRECCIÓN Street Address City State / Province / Region ZIP / Postal Code Phone/Número de teléfonoEmail/Correo electrónico Job Title/Título profesional Worker Trainer Supervisor Human Resources Unemployed Other Type of Employment/Tipo de empleo Permanent Seasonal Third Temporary What is grown in your workplace?/¿Qué se cultiva en su lugar de trabajo? Tree fruit Potatoes Wheat Berries Dairy Wine grapes Hops Other Is this your first time attending?/¿Es esta la primera vez que asistes? Yes No What are you hoping to gain from participating in the event?/¿Qué espera obtener al participar en el evento?How did you hear about this opportunity?/¿Como te enteraste de esta opotunidad?
