Clay Hills Ag Aerial Applications - Clay Hills Ag

Information for Aerial Application

Grower Info

Field Location/Info

* Indicates required field

Grower Name/Company: *

Grower Address: *

Line 1

Line 2

City

State

Zip Code

Country

Grower Phone Number *

Name of person to call if pilot has questions: *

Number of person to call if pilot has questions: *

Billing Name *

Billing Address *

Line 1

Line 2

City

State

Zip Code

Country

County: *

Section: *

Township: *

Range: *

Crop Type: *

Bee Law (Bee Farm in the area): *

Yes No

If yes, how close? *

Sensitive Crop (Organic Farm in the area): *

Yes No

If yes, how close? *

Please include a pdf document of the applied field *

Max file size: 20MB

Product To Be Applied

Product *

Product *

Product *

Product *

Product *

Per Gallon Or Ounce Per Acre *

Select One *

Select One *

Select One *

Select One *

Rate Of Application *

Rate Of Application *

Rate Of Application *

Rate Of Application *

Rate Of Application *

Submit