AM/PIC Registration

2026 GACAA AM/PIC Registration

Georgia Association of County Agriculture Agents

PLEASE PRINT THIS FORM BEFORE YOU HIT SUBMIT SO YOU HAVE A COPY.

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City State ZIP

Office Phone(Required)

Cell Phone

Agent Information

County/State Staff/Specialist(Required)

Enter your county name, state staff, or specialist

District/State Staff(Required)

Enter Northwest, Northeast, Southwest, Southeast or State Staff

Meals needed:(Required)

Monday November 9 - New member meet & greet, 5 - 5:30 pm

Monday November 9 - Social & meal, 5:30 - 7:30 pm

Tuesday November 10 - Breakfast, 7 - 8 am

Tuesday November 10 - Lunch, 12:20 - 1:20 pm

Tuesday November 10 - Social & Annual Banquet, 6 - 9 pm

Wednesday November 11 - Breakfast, 7 - 8 am

These meals are included in your conference registration. Please select all that you will be attending.

Vegetarian meals?

Yes

No

There is a box below if there are other dietary restrictions that we need to know.

Activities/Tours(Required)

Monday November 9 - Golf, 1-4 pm

Monday November 9 - Skeet shooting/Jelly Ball, 1-4 pm

Monday November 9 - Little Acres Farms (make a garden bowl), 1-4 pm

Tuesday November 10 - Tour 1: GA Museum of Agriculture

Tuesday November 10 - Tour 2: Bandwagon Brewery

Tuesday November 10 - Tour 3: Lewis Taylor Farms

Tuesday November 10 - Tour 4: Kelly Manufacturing Co.

Tuesday November 10 - Tour 5: Holy Land Farms

Tuesday November 10 - Tour 6: From the Fields Meat & Processing

None

Please select one Monday activity and one tour for Tuesday. There will be out of pocket fees for Monday activities, amounts TBA. Some tours may have a number limit due to transportation availability so attendees will be added first come first served. All tours will be 1:30 pm to 5:00 pm.

Conference Cost(Required)

Pay by Card ($180+$5 Convenience Fee)

Pay by Check ($180)

Tuesday only/Banquet By Card ($70+$5 Convenience Fee)

Tuesday only/Banquet ($70)

A $5 convenience fee is included for paying by credit card.

Final Price

If you are paying by check please print and mail with your payment to: Justin Odom, GACAA Treasurer, 426 N. Friendship Ave., Donalsonville, GA 39845

Credit Card

Cardholder Name

Card Details

Any other special needs or requirements (dietary, mobility, physical)? Please indicate in box below.

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