Farmer Technical Assistance Request Farmer Technical Assistance Request This form is for farmers in Clallam, Jefferson and Kitsap Counties to submit general farm assistance requests, including pest identification and management requests, to our Regional Small Farms Team and IPM Specialist. Name* First Last Farm Name:* County you farm in:*ClallamJeffersonKitsapNumber of years your farm has been in business*0 - just starting out1-3 years4 - 6 years7 - 10 years10+ yearsWhat is the acreage size of your farm or land you farm?* Address of Farm* Street Address Address Line 2 City ZIP Code Email* Phone*What technical assistance are you looking for?*Please be as specific as possible with type of assistance needed. For Pest Specific assistance you will fill in a separate field below. Are you having a pest (insect, disease or invasive weed) issue on your farm?*YesNoIf this is a pest assistance request (insect, disease or invasive weed), please list the Pest Problem/Issue you are experiencing:Please describe in detail the pest issue in which you are requesting assistance for. You will have the ability to also upload pictures at the end of this form. How long have you been experiencing this pest issue? What crop(s) are being affected? Is there anything else you think we should know or additional info you would like to share?FilePlease provide photos that clearly show the pest or problem you are experiencing. This will aid our Regional Small Farms Team in reviewing and preparing a response to your request for assistance. Drop files here or Select files Max. file size: 195 MB.