Participants are accepted on a first-come, first-served basis. No final papers from teachers will be accepted after March 25, 2009 . Participants are responsible for a $100 non-refundable registration fee.

Two Ways to Register

1. Register electronically. After you fill out the application below and submit it, you will be automatically taken to the Paypal website. You will be able to securely use a credit card (VISA, MasterCard, American Express or Discover) to pay the registration fee whether or not you have an account with Paypal. If you have a Paypal account, you may use your Paypal account to pay for the registration.

2. Print out an application and return it via US mail with your check.

Participants should submit this form with a $100 non-refundable registration fee the address below. Application will not be complete until payment is received at Pennsylvania Farm Bureau.

Please make checks payable to:
Pennsylvania Friends of Agriculture Foundation
c/o Ag in the Classroom
PO Box 8736 · Camp Hill, PA 17001-8736

After you fill in the form below and submit the information, you will be taken to Paypal's secure payment page. You may choose to use VISA, MasterCard, American Express, or Discover through Paypal. It is not necessary to have a Paypal account to do so. If you do have one, you may also log in and use your own Paypal account.

*Must be filled in.

Teachers are personally responsible for a $100 fee with their FINAL information form.

I have a sponsor: Yes       No

1. Please provide your PPID¹ here:

2. Please indicate credits you wish to apply for:

60 Act 48 hours

2 IU Professional Education Graduate Credits. IU fees for credits are the responsibility of the participant.

2-3 Penn State Graduate Credits (PSU will send information only to those wanting graduate credits). PSU fees for credits are the responsibility of the participant.

None

has agreed to be my roommate.
Roommates Name:

Assign a roommate to me. (Take this opportunity to get to know another teacher.)
I require my own room. (You will be responsible for 1/2 the room charge)
I live close enough to commute. (Classes begin at approx. 8 a.m. and end each day approx. 8 p.m.)

Who recommended this course to you?

Please include me (work contact information only) in the AITC Educators Directory.

Yes   No

All registration forms and payments must be received before March 25, 2009 . Registration fee must be paid prior to receiving sponsorship assistance. Sponsorships are awarded in accordance to the sponsoring organizations instructions and on a first-come-first-serve basis.

PA Farm Bureau    WWW