County Co-op Request Form

Submit one county project per form and please be prepared to attach:

Proof of payment, such as a receipt, invoice, copy of check, etc.
2. Proof of the county organization’s involvement or contribution such as a photo, signage, newspaper article, social media post, thank you note, radio script, event program, etc.

See the County Coop Program Guidelines for more information.

If you would prefer to fill out a physical copy of the form, you can download that here.

For questions, contact Addison Randall: arandall@iowapork.org

County Organization Info

Which county pork group are you associated with?

Contact Person:

Address:

Address Line 2:

City:

State:

Zip Code:

Phone:

Email:

County Promotion Description

What was this project?

Please describe the promotion in detail:

Location & date of promotion:

How was pork and/or producer image promoted by this activity?

Total County Dollars Spent on this promotion:

Dollars Spent:

Attachments

Proof of payment, such as a receipt, invoice, copy of check, etc.

Proof of the county organization’s involvement or contribution such as a photo, signage,newspaper article, social media post, thank you note, radio script, event program, etc.

Additional Document 1 (Optional):

Additional Document 2 (Optional):

County Contact Signature

Name of individual signing off:

Acknowledgement:

I certify that the information stated above is accurate.

By providing programs and resources for all Iowans, IPPA is dedicated to the state, and especially to rural Iowa.

IPPA is committed to serving Iowa's pork producers with education, information and research.

IPPA has many types of memberships. Find the one right for you.

County Co-op Request Form

Submit one county project per form and please be prepared to attach:

County Organization Info

This program is only available for county pork groups.

County Promotion Description

Total County Dollars Spent on this promotion:

Attachments

County Contact Signature