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2019 Ag Literacy Reader Registration

Please use this form to register to be a Volunteer Reader in a classroom March 18-22, 2019 to celebrate Ag Literacy Week across Pennsylvania!


We are asking volunteers to identify a school(s) and classroom(s) in their area to read to as part of our PA Ag Literacy Week program. If you don’t know of a school in your area, you may contact us at alw@pfb.com and we will be happy to share the contact information for some of your local schools with you, so you can reach out to them and request to read to a classroom.

Please have this list of information ready for each classroom before filling out the form:


1. Contact Information

First Name*
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Last Name*
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Email*
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Telephone - please do not use parenthesis or hyphens*
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Address*
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Address 2
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City*
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State*
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Zip*
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County*
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If you are reading as an affiliate of an agricultural organization, please enter the organization name below.
Organization Name
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# of Classrooms
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If you have more than 10 classrooms, we will send you a form to submit your classroom information. This is to avoid you having to do multiple registrations as our system can only accommodate 10 classrooms per registration.

Have you participated in ALW before?*

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2. Participation Information

At least a month prior to Ag Literacy Week, I will make arrangements with the teacher(s) for my visit(s), and coordinate with each teacher the specific day and time I will visit their classroom to read during the 3rd Annual PA Ag Literacy Week, March 18-22, 2019.
Do you agree?*
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3. Material Delivery

Once you register with a classroom, we will email you an invoice by the beginning of February for the $10 per classroom to cover the book being donated by you to the classroom library. Books and all necessary activity materials to complete your visit to the classroom will be available by the beginning of February.


How would you like to receive your materials?

Preferred Material Delivery Method*

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Delivery Date Options
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I’d like to donate an extra $3 per book to cover the cost of shipping*
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4. Classroom Information

To assist us in properly preparing your packet of materials for your visit, as well as allowing us to provide the classroom teacher with additional materials, we ask that you provide the following information for each Kindergarten-2nd grade classroom you intend to visit:

Do you already have a class in mind for the project?*

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If you already have your classrooms scheduled, and you have 10 or fewer classrooms, please provide the following information for each of the classrooms matched with your readers

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 press the submit button below.

If you are still working on getting your classroom information.
please continue to fill in this form. Remember to email your classroom to us directly at alw@pfb.com
no later than January 15.

Please press submit button below


Please be sure to fill in all of the questions for each classroom to whom you are reading.

CLASSROOM #1

Teacher First Name
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Teacher Last Name
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Teacher Email
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Grade
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Number of Students
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School District
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County of School
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Elementary School Name
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Do you have another classroom?
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Comments or Requests
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CLASSROOM #2

Teacher First Name
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Teacher Last Name
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Teacher Email
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Grade
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Number of Students
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School District
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County of School
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Elementary School Name
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Do you have another classroom?
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Comments or Requests
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CLASSROOM #3

Teacher First Name
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Teacher Last Name
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Teacher Email
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Grade
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Number of Students
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School District
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County of School
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Elementary School Name
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Do you have another classroom?
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Comments or Requests
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CLASSROOM #4

Teacher First Name
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Teacher Last Name
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Teacher Email
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Grade
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Number of Students
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School District
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County of School
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Elementary School Name
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Comments or Requests
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Do you have another classroom?
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CLASSROOM #5

Teacher First Name
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Teacher Last Name
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Teacher Email
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Grade
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Number of Students
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School District
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County of School
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Elementary School Name
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Do you have another classroom?
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Comments or Requests
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CLASSROOM #6

Teacher First Name
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Teacher Last Name
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Teacher Email
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Grade
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Number of Students
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School District
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County of School
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Elementary School Name
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Do you have another classroom?
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Comments or Requests
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CLASSROOM #7

Teacher First Name
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Teacher Last Name
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Teacher Email
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Grade
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Number of Students
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School District
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County of School
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Elementary School Name
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Do you have another classroom?
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Comments or Requests
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CLASSROOM #8

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Teacher Email
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Grade
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School District
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County of School
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Elementary School Name
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Do you have another classroom?
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Comments or Requests
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CLASSROOM #9

Teacher First Name
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Teacher Email
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Grade
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Number of Students
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School District
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County of School
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Elementary School Name
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Comments or Requests
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Do you have another classroom?
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CLASSROOM #10

Teacher First Name
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Teacher Last Name
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Teacher Email
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Grade
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Number of Students
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School District
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County of School
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Elementary School Name
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Comments or Requests
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