Free 50246.pdf - Indiana

HOOSIER HOMESTEAD NEWSPAPER PRESS RELEASE
State Form 50246 (R2 /4-03)

Please review the following information. It will be used to personalize your certificate. If any information is incorrect, please call us at 317/232-1360. County: Award Name: Farm Origin Date: List all family members who will be in the picture taken at the ceremony.

G Please check box if your family will not be able to attend the award ceremony.
MEDIA INFORMATION We will send a copy of your photograph taken at the award ceremony to one (1) newspaper of your choice. Please furnish the information below: Name of Newspaper: Contact Person: Address: City: Telephone Number: ( ) Return completed form to: Hoosier Homestead Award Program Office of the Commissioner of Agriculture ISTA Center - Suite 416 150 West Market Street Indianapolis, Indiana 46204-2810 State: IN Zip Code: