NORTH CAROLINA JAYCEES

2013 Outstanding Young Farmer

Nomination Form

This purpose of the Outstanding Young Farmer is to foster better urban-rural relations through Jaycee farmer contacts and by creating a greater public interest in/and understanding of today's farmer. The young person selected as the community's Outstanding Young Farmer will receive local recognition and will become a nominee in the state finals.

The judging criteria will be based on:

- Progress in agricultural career (50%)

- Extent of soil and water conservation practices (25%)

- Contributions of the well-being of the community, state and nation (25%)

Nominee Qualifications

  1. Nominee must be between the ages of 21 and 40 as of January 1, 2013.
  2. Be actual farm operators, deriving a minimum of 2/3 of their income from their farming.

Requirements for Nomination

1.  Entry form must be completed. Background information and questions may be completed on this form or additional sheets. Use black ink or type.

2.  Nominee must sign this form on page 2.

3.  NATIONAL COMPETITION ONLY: A financial statement will be required of the state winner for National competition. Financial statements are not required for local and state competition.

4.  Nomination form and attachments must be submitted to the local Jaycee chapter by April 6, 2013.


Chapter mailing address: Raleigh Jaycees (Attn: 2013 DSA), P.O. Box 20244, Raleigh, NC 27619.
Must be postmarked on or before 4/6/13.
Chapter email address: Email to by 11:59 pm on 4/6/13.

Background Information

Nominee Name: / Age: / Birth date:
Address:
City/State/Zip:
Home Phone:
Marital Status: / Spouse's Name:
Children (Names/Ages):
Type of Farm Operation:
Schools attended (schools, academic honors, etc) :

General Information

Number of years as a farm operator: / Percentage of total income earned from farming:
Total annual income earned from farming:
Number of days spent in "off-farm" employment: / What is the "off-farm" employment:
Is Nominee: Sole Proprietor Partner Salaried Manager Other (please list)
If other than sole proprietor, what percentage of policy and management decisions do you make?
Indicate the total number of acres operated: / Tillable: / Grazing or non-tillable:
Of the above total, indicate the number of acres:
Owned individually: / Owned in partnership: / Percentage owned in partnership:
Rented individually: / Rented in partnership: / Percentage owned in partnership:

Progress in Agricultural Career (50 points)

How and when did nominee get started?
What challenges has nominee faced and overcome?
What help has nominee received, including inheritances, gifts, family partnerships, etc?
Has nominee experimented with new production practices or developed new machinery? If so, describe.
What farm records are kept and how are they used in management analysis?
Why did nominee enter farming and what were his or her goals? What are they now?
What is the nominee's spouse's occupation and/or contribution to the farm operation?

Extent of Soil and Water Conservation Practices (25 points)

Comment on any/each of the following as they may pertain to soil type and topography of nominee's operation.

A. Soil Improvement (soil testing, fertilizer practices, soil structure, green manure, weed control, grazing practices).
B. Erosion Control (wind and water)
C. Water Management (irrigation, drainage, waterways, ponds)
D. Reforestation, Woodland Improvement, Wildlife, and Recreation Land Uses
E. Home and Farmstead Improvements

Contributions to Community, State, Nation (25 points)

Membership and offices held in organizations by the nominee and spouse.

Organization / How Long a Member / Offices Held

Summarize those contributions you consider to have been the most important.

Nominee Signature

I certify that, to the best of my knowledge and belief, the statements given truly represent my background and activities. I give permission for the facts to be used in publication.

Signature of Nominee

LOCAL CHAIRMAN ONLY

Deadline for receipt of entries to state competition is April 17, 2013. Please email nomination form and attachments to . Entry fee of $5 can be mailed to NC Jaycees 6300 Creedmoor Road, Suite 170 #257 Raleigh, NC 27612 or paid using Paypal via the NCJC State Website.

I certify that the above name is of the duly selected nominee of the Jaycees and is our official entry in the North Carolina Jaycees State Competition.

Chapter President:

Address:

Phone:

Signature of Chapter President

Will Nominee be available to attend the State Awards Banquet on May 4, 2013? Yes No


Financial Information (To be completed by State Winner Only)

CROP AND LIVESTOCK PRODUCTION HISTORY

ITEM / YEAR STARTED
(as a full time operator) / CURRENT YEAR
(or last three-year average)
Crops / Acres / Yield/Acre / Total $ Sales / Acres / Yield/Acre / Total $ Sales
Livestock (types and breeds) / Number / Production per Unit / Total $ Sales / Number / Production per Unit / Total $ Sales
Total Crops and Livestock
Describe what changes of production and/or marketing techniques occurred and why:

PROGRESS IN NET WORTH - STRICTLY CONFIDENTIAL

Judges are not looking for the wealthiest farmer, but for the one whom has successfully increased net worth through good farm practices and management. All figures should reflect the increase today as against the time the nominee started farming. Financial statement should reflect the nominee's share only. NOTE: This form is required for national competition and is optional for local or state competition. For national competition, the nominee may choose to copy this form on a white 8 1/2" x 11" sheet of paper placing five copies in separate envelopes to be opened only by the judges.

FINANCIAL STATEMENT / Year started as full time operator / Current Year
Original Cost to Operator / Then Market Value / Original Cost to Operator / Current Market Value
Current Assets / Cash and equivalents, marketable securities, accounts receivable, inventory, supplies, prepaid expenses, cash in crops, etc.
Intermediate Assets / Breeding stock, automobiles, machinery and equipment, co-op stock and retains, etc.
Fixed Assets / Farm real estate, other real estate, etc.
Total Assets
Original Amount / Original Amount of Current Loans / Current Unpaid Portion
Current Liabilities / Accrued expenses, deferred taxes, real estate taxes, rents and leases payable, current maturities, capital lease payments, contract payments, notes payable, etc.
Intermediate Liabilities / Notes payable, installment contracts payable, leases payable, other payables, etc.
Long Term Liabilities / Notes payable, contracts and leases payable, real estate debt, etc.
Total Liabilities
Net Worth of Nominee
CERTIFICATION OF FINANCIAL INFORMATION / Name:
MUST be certified by nominee's banker, accountant, or financial management service. REQUIRED OF STATE WINNERS. / Title:

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