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Farm bureau car seat program

Farm bureau car seat program 2026

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44 votes

The document is an order form for the Southern Farm Bureau Casualty Insurance Child-Saver Program, detailing the purchase of convertible car seats and high back booster seats. It includes instructions for completing the order, payment methods, and contact information for customer service. The form specifies that all fields must be filled out, no fax or phone orders are accepted, and provides pricing for the seats.

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Click ‘Get Form’ to open the farm bureau car seat program order form in the editor.
Begin by entering your Farm Bureau Member Number and State, as these are required for processing your order.
Fill in your Name, Daytime Phone Number, and Address (ensure it is a physical street address, as PO Boxes are not accepted).
Select the desired car seat model from the options provided. Note that there is no choice in fabric pattern or color.
Indicate the Quantity of each car seat you wish to order and calculate the Total Cost based on the member prices listed.
Make your check payable to Child Source and send it along with the completed order form to the specified address.
For any questions regarding your order, ensure you have your Farm Bureau member number ready when calling customer service.

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Versions	Form popularity	Fillable & printable
2016	4.8 Satisfied (242 Votes)
2013	4.4 Satisfied (44 Votes)
2010	4.2 Satisfied (39 Votes)

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