Strengthening the Food Resource Safety Net 8th Annual Conference

Personal Information

* Last Name:

 

* First Name:

 

* Title (for example Nutrition Educator, Volunteer, etc):

 

* Organization:

 

* Street Address 1:

 

Street Address 2:

 

* City:

 

* State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

* Zip Code:

 

* Daytime Number
(Include Area Code):

 

Fax Number
(Include Area Code):

 

* Email:

 

Are you a member of the PA NEN?

  Yes No

* Conference Attendance

Please select which day(s) you would like to attend
Entire Conference: May 20-21 ($130)
Tuesday, May 20 One Day ($60)
Wednesday, May 21 One Day ($75)

* Meal Preference

Please select one
No Preference
Vegetarian

If you have any questions regarding the registration process please contact Julie Masteller @ 717-233-1791 or jmasteller@pahunger.org

Workshop Options

Please choose one topic from each workshop you are interested in attending.

* Payment

How do you wish to pay?
Please select one
Credit Card (per what's available via PayPal)
Send in check
Send/Call in Credit Card

Please make checks payable to Pennsylvania Hunger Action Center and send to:

Strengthening the Food Resource Safety Net
Pennsylvania Hunger Action Center
208 N. Third Street, Suite 200
Harrisburg, PA 17101
FAX: (717)231-4085