2019 Ag Literacy - Register A Group

Are you a teacher or leader for a volunteer group, such as FFA or 4-H, who has worked to identify local Kindergarten-2nd grade classrooms where your members can participate in our PA Ag Literacy Week program as part of your community outreach?


Please use this form to Register a Group of Volunteer Readers for your identified classrooms
March 18-22, 2019 to celebrate Ag Literacy Week across Pennsylvania!


Please have this list of information ready for each classroom before filling out the online 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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Name of Group or Organization*
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# of Classrooms*
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Has your group participated in ALW before?

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2. Participation Information

At least a month prior to Ag Literacy Week, I will make sure our group members have made arrangements with the teachers for our group’s visits and have coordinated with each teacher the specific day and time our group member 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 to each classroom. Books and all necessary activity materials to complete your visit to the classroom will be available by 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

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.

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 your group intends to visit:

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.

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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Elementary School Name*
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School District*
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County of School*
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Reader's First Name
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Reader's Last Name
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Reader's Email
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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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Elementary School Name*
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School District*
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County of School*
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Reader's First Name
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Reader's Last Name
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Reader's Email
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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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Elementary School Name*
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School District*
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County of School*
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Reader's First Name
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Reader's Last Name
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Reader's Email
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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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Elementary School Name*
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School District*
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County of School*
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Reader's First Name
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Reader's Last Name
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Reader's Email
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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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Elementary School Name*
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School District*
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County of School*
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Reader's First Name
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Reader's Last Name
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Reader's Email
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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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Elementary School Name*
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School District*
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County of School*
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Reader's First Name
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Reader's Last Name
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Reader's Email
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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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Elementary School Name*
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School District*
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County of School*
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Reader's First Name
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Reader's Last Name
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Reader's Email
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Do you have another classroom?*
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Comments or Requests
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CLASSROOM #8

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