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Sowing Change: Promoting Food Access Through Gardening- Feb 17, 2017
---------------------------------------------Section I: Registrant Information----------------------------------------------
*First Name:
*Last Name:
*Institution/Organization
*Position/Title
*If faculty, list discipline
*Email:
*Address Line 1:
Address Line 2:
Address Line 3
*City:
*State:
*Zip Code:
*Registration Costs Per Person
*Will you bring a poster presentation?
If Yes, please give presentation title
Dietary Needs
If Other selected above, please describe:
Other Special Needs:
-------------------------------------------Section II: Payment Information-------------------------------------------
We do not have the ability to accept electronic payments. Please follow the instructions below to complete your registration and submit payment by February 8, 2017.

Registration is limited to the first 100 registrants!

Registration costs per person:
$25 Per Faculty/Staff from Campus Compact member institutions
$40 Per Faculty/Staff from Non-Campus Compact member institutions
$15 Per Community Partner (limited to 3 per organization)
Free for Students

Please send payment AND a copy of registration form (print this page) to:

Pennsylvania Campus Compact
28 South Dewberry Street, Box 8
Harrisburg, PA 17101

All checks must be received by February 8, 2017. Checks can be made payable to Pennsylvania Campus Compact.

Questions regarding payment can be directed to Michele Lowrey
at mlowrey@paccompact.org or 717-796-5072 ext. 1.
Final Confirmation
Prior to hitting the submit button below, please print this page for your records and include with your payment.

Your registration is NOT complete until you hit the submit button.
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