2020 ALW Group Registration

2020 ALW Group Registration
If you are a teacher, leader, or coordinator for a volunteer group, such as FFA, 4-H or county farm bureau, please use this form to register your group of readers for our 4th Annual Ag Literacy Week program during the week of March 16-20, 2020!
1. Contact Information
Name *

First Name Last Name
Email *
example@example.com
Phone Number *

Area Code Phone Number (xxx-xxxx)

Address *

County *
Organization Name
Total # of Classrooms *
Number of classrooms you will be visiting and reading to during Ag Literacy Week
Estimated # of Readers *
Number of individuals you estimate will be reading with your group
Have you participated in ALW before? *

Yes, and we want to participate again this year No, but we are looking forward to participating this year

2. Participation Information
At least a month prior to Ag Literacy Week, I will will make sure our group's members have made arrangements with the teachers for our group visits and have coordinated with each teacher the specific day and time our group member will visit to their classroom to read during the 4th Annual PA Ag Literacy Week, March 16-20, 2020.
Do you agree? *

I Agree

4. Classroom Information
To assist us in properly preparing your packets of materials for your visits, as well as allowing us to provide the classroom teachers with additional educational materials related to agriculture, we ask that you provide the following information for each Kindergarten-2nd grade classroom your group intends to visit:
Do you already have classes in mind for the project? *

Yes, and I have the classroom information to submit below Yes, and I have more than 10 classrooms. Yes, but I am working on getting the necessary information

Our system will not permit more than 10 submissions at a time, so to avoid having you complete multiple online registrations, we will email you a form to complete with your classrooms’ information.

Please continue to the Payment Information Page.

5. Payment
I understand that there is a $10 donation fee per classroom to cover the cost of the book, which will be given to the classroom teacher following my Ag Literacy Week Visit.
Do you agree to pay the $10 per classroom fee to cover the book cost ? *

I Agree
I would like to pay by: *

Credit Card Invoice

Please send invoice to: *

Payment for my books *

Books $ 10.00

Number of Classrooms

I would like to help with the credit card processing fee of 30 cents per book (optional). $ 0.30

Number of Books

Total $ 0.00

Review & Submit
Please use the "REVIEW" button to review all of your Ag Literacy Registration, then press submit to complete your registration.
Should be Empty:

Invoice Payment Information