Farmer Assistance Request Form Program Contact: Kathryn Hoogheem, Agriculture Extension Coordinator (509) 684-2588 • firstname.lastname@example.org Farmer Assistance Request This form is for farmers in Stevens County to submit general farm assistance requests, including pest identification and management requests. Name(Required) First Last Farm Name: Number of years your farm has been in business:0- Just starting out1-3 Years4-6 Years7-10 Years10+ YearsAddress of Farm(Required) Street Address Address Line 2 City ZIP / Postal Code Email(Required) Enter N/A if you do not have an email address.Phone(Required)What assistance are you looking for?(Required)Please be as specific as possible with type of assistance needed. For Pest Specific assistance you will fill in a separate field below.Pest SectionAre 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.What crop(s) are being affected? FileMax. file size: 195 MB.Please provide photos that clearly show the pest or problem you are experiencing. This will aid us in reviewing and preparing a response to your request for assistance.