2016 Registration Form First come, first serve! Only 20 Spots! Fayette County Extension Fayette County Current 3rd-5th Graders $25 Thank you to the Fayette Master Gardener Association -please Junior Master for supporting this program. Name: School: Gardener Program Fayette County Extension Office Grade Now:_ Birthday:_ _/ /_ 140 Stonewall Ave. West, Suite 209 Address: Fayetteville, GA 30214 City:_ Zip: 770-305-5412 x7 Parent’s Name: Home Phone:_ Cell Phone:_ Email: Boy Girl Race* □ □ *This information is optional, but will assist us in record keeping under Federal Guidelines. Circle T-Shirt Size (Youth Sizes): Small Medium Large X-Large The University of Georgia and Ft. Valley State University, the U.S. Department of Agriculture and counties of the state cooperating. The Bring completed registration form along with Cooperative Extension offers educational programs, assistance and Current 3rd-5th Graders camp fee (check to Fayette County Extension/ materials to all people without regard to race, color, national origin, age, sex or disability. An equal opportunity/affirmative action organization 4-H, cash, or credit card). committed to a diverse work force.
Registration Form Fayette County Extension Current 3rd-5th Graders $25 -please Name: School: Grade Now:_ Birthday:_ _/ /_ Address: City:_ Zip: Parent’s Name: Home Phone:_ Cell Phone:_ Email: □ Boy □ Girl Race* *This information is optional, but will assist us in record keeping under Federal Guidelines. Circle T-Shirt Size (Youth Sizes): Small Medium Large X-Large Bring completed registration form along with camp fee (check to Fayette County Extension/ 4-H, cash, or credit card). First come, first serve! Only 20 Spots! Thank you to the Fayette Master Gardener Association for supporting this program. Fayette County Extension Office 140 Stonewall Ave. West, Suite 209 Fayetteville, GA 30214 770-305-5412 x7 The University of Georgia and Ft. Valley State University, the U.S. Department of Agriculture and counties of the state cooperating. The Cooperative Extension offers educational programs, assistance and materials to all people without regard to race, color, national origin, age, sex or disability. An equal opportunity/affirmative action organization committed to a diverse work force. 2016 Fayette County Junior Master Gardener Program Current 3rd-5th Graders
JMG%202016%20registration.docx