M Casa Enterprises


(Please type or print.  Print out this form and mail it with your check to the mailing address below.)


Name:  __________________________Soc. Sec. #:_____-___-_____


Name exactly as it should be printed on completion certificate:



Address:  ________________________E-Mail: __________________


City:__________________State: ________________ Zip: __________


Home Phone #:___________________ Cell #:____________________


Work Phone #:___________________


Tuition Fee: 

$100.00   Payment is due at registration submission and is non-transferable and/or non-refundable.

$50.00    Payment for any of the other business partners (or spouse) to have a certificate in their name

(all of the work must be done by that individual also).


** This is the Financial Management Training Program approved by the Farm Service Agency to meet the required Farmer Borrower Training Requirements. This Vendor makes no other claims or warranties, either stated or implied.**


FSA Information:


State:_________________  Dist/County Office:___________________


County Supervisor:__________________ Phone:__________________


Fax: __________________


Mailing Address of Office: ___________________________________





Signature: ________________________________________________


Mail to:            Karen Harlan

                        P.O. Box 1393

                        Seagraves, TX  79359

                        Fax #:  (806) 546-0079

                        (806) 546-0409


Work to be Submitted