2008 Life Science Field Training Institute - Application Form

Please complete this form and mail it to us with your registration fee of $350.00 payable to Pinelands Preservation Alliance.
Note that arrangements for graduate credit, including additional fees, will be arranged through Rutgers University. Contact Mike Hunninghake (contact info below) for more information.

You can register on-line by going to www.pinelandsalliance.org, selecting the Education button and following the links to the Life Science Field Training Institute.

Who are you?

First Name: Last Name:
Home Address:
City: Zip:
Home Phone: E-mail address

Where do you work?

Name of School:
School Address:
City:
Zip:
School Phone:
Grade:
Subject taught:

Do you have a particular Pinelands interest?

Yes No
What is it?

Please print this application form and send it with your $100 registration check to:
Mike Hunninghake
Pinelands Preservation Alliance
17 Pemberton Road
Southampton, NJ 08088
If you need any more information, please call us at (609) 859-8860 or e-mail mikeh@pinelandsalliance.org