Participants are accepted on a first-come, first-served basis. No final papers from teachers will be accepted after June 1, 2007. Sponsors should submit this form with a $700 check payable to:

Please make checks payable to:
Pennsylvania Friends of Agriculture Foundation
PO Box 8736
Camp Hill, PA 17001-8736

Application will not be complete until payment is received at Pennsylvania Farm Bureau.

Date Submitted:

Name of Nominating Organization and/or Person:

Address:

Email:

Phone:


County:

Name of Participant:

Home Address:

Email:

Home Phone:

County:


School District:

School:

Grade(s) and Subject(s):

Participants are personally responsible for a $100 fee with their application. Sponsors should not collect this fee.

The participant is interested in :


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.

Act 48 hours

No credit information