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Dairy Alert is committed to providing you with the most useful information possible for you and your business. Dairy Alert eNewsletter is delivered every Wednesday by email. To better serve you please take a minute to complete a simple survey. Help us make Dairy Alert even better and your name will be entered into a weekly drawing for prizes of $50, and a monthly prize of $500. Our grand prize is $2,500! Good Luck and thank you for sharing your information with us. 
 
General Information
 
* First Name: 
 
* Last Name: 
 
* Email: 
 
* Confirm Email: 
 
Address Line 1: 
 
Address Line 2: 
 
City: 
 
State: 
 
Postal Code: 
 
* Phone: 
 
Other Information
 
Livestock Activity
 
  If you have no activity in some categories please write none or zero.
 
* What is your dairy herd size (milking & dry cows): 
 
* What is your total # of dairy replacement heifers: 
 
* What is your total # of dairy replacement calves: 
 
* Rolling herd average pounds of milk produced: 
 
Crops Grown
 
  If you have no activity in some categories please write none or zero.
 
* Total acres owned or leased: 
 
* Corn acres for grain: 
 
* Corn acres for silage: 
 
* Soybean acres: 
 
* Alfalfa acres: 
 
* Other hay acres: 
 
* Pasture acres: 
 
* Other silage: 
 
* What % of your total acres are organic feed: 
 
What is your title: 
  Owner, Co-Owner, Officer
  Herdsman
  Manager/Foreman/Supervisor
  Hired Hand/Employee/Milker
  Contract Heifer Grower
  Other, please specify below
 
  please check only one
 
Other: 
 
Occupation if not a Dairy Farmer/Producer/Employee: 
  Veterinarian, Private Practice
  Veterinarian, Company
  Veterinarian, Govt, University, Other
  Veterinarian Student
  Meat Packer, Processor
  Banker, Financial Inst
  Extension Svc, County Agent, Government
  Educator/College/Univ
  Consultant (Not Veterinarian)
  Nutritionist
  DHIA Personnel
  Hoof Trimmer
  Milk or Cheese Processor
  Milk Hauler/Transportation
  Other, please specify below
 
Other: 
 
* What is your primary business at this location: 
  Dairy Farmer/Milk Producer
  Dairy/Calf and/or Replacement Heifer Grower
  Other (please specify below)
 
Other: 
 
*   
Quantity     Item
 
    Number of employees on this Ranch/Feedlot/Farm
 
    Including yourself and other working family members
 
How do you get Industry Information?
 
  
 Dairy Herd Management
 
  
 Other Magazines
 
  
 Internet
 
  
 Mobile Device
 
Would you like to receive the following free emailed Newsletters?
 
  
 Dairy Alert (emailed weekly)
 
  
 Dairy Exec (emailed monthly)
 
  
 Calf & Heifer (emailed monthly)
 
  
 CattleNetwork News (emailed daily)
 
Do you use any of the following items in your operations?
 
  Please indicate how many. If you have no activity in some categories please write none or zero.
 
ATV (#): 
 
Skid Steer (#): 
 
Tractor Color: 
 
Tractor Horsepower: 
 
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