Bayer Representative

Please ensure that you are the Bayer Rep. for this particular grower. If you are not or are unsure, please do not add the grower to the PRS program.

First Name (Bayer Rep.)

Last Name (Bayer Rep.)

Grower Contact Method

Please indicate how you, the Bayer Representative, contacted the grower and secured their agreement to opt in to and receive communications from the Bayer PRS program.

Please Specify

Email
Phone
In-person

Retailer Information

Enter the retailer company name as well as the first and last name of the grower’s retailer representative.

Company Name (Retailer)

City (Retailer)

State (Retailer)

First Name (Retailer Rep)

Last Name (Retailer Rep)

Grower Information

This section is for grower information only.

First Name

Last Name

Email (optional)

Phone

Grower ID (optional)

Loyalty ID (optional)

Company/Farm Name

Address

City

State

ZIP Code

Opt in to receive direct mail communications from Bayer about crops, products, and other information supporting your business.

Opt in to receive emails from Bayer about crops, products, and other information supporting your business.

By clicking submit, you as the Bayer Representative, are opting the grower into the program to receive communications from Bayer.

PRS Grower Sign-up/Update

green combine wideshot preferred retailer support

Before You Proceed:

Before submitting any new and/or updated grower information, please ensure that you have successfully received a clear opt-in confirmation from your grower to be contacted through the PRS program. If this confirmation has not yet been received, please hold on submitting this form.

If you have received an opt-in confirmation from a new grower, would like to update an existing grower’s information, or would like to remove a grower from the program, please read through the “Adding/Updating/Removing A Grower” section below to navigate to the correct page.

Remember, if you are updating an existing grower’s information, you will need to resubmit all of the requested fields.

Adding/Updating/Removing A Grower

Add or update a grower using the form below. To update a grower, please resubmit their updated information using the same form below.
Remove a grower by giving us a little information via the removal form

PRS Grower Sign-up/Update

All fields required unless otherwise noted