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Apply Now

Instructions: Please complete the form below. Avoid using the Web browser's back and forward buttons. The application will not work correctly if you use these buttons. The fields indicated in *bold blue and asterisk* are required. When your information is received, a Penn State representative will follow up with you to complete the application process. If you need assistance or would like to apply by phone, please call.

  an Penn State Outreach  program of Penn State Continuing and Professional Education in collaboration with the College of Earth and Mineral Sciences

This site is a product of Penn State Outreach Marketing and Communications.
Program Questions? E-mail John Dolan, or call him at 814-865-2216.
Web site questions? E-mail WebInfo@outreach.psu.edu.
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Page last modified on Monday, May 21, 2007
Contact Information
First name:*

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Last name:*

Home address:*

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ZIP code:* +4 (optional):

Home phone:*

Fax number:

Work phone:

Yes, it is okay to call me at home.
No, please do not call me at home.
Yes, it is okay to call me at work.
No, please do not call me at work.
Please indicate the time you would prefer to be called:

E-mail address:*

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By providing your e-mail address, you are authorizing Penn State faculty and staff to contact you by e-mail for administrative and course-related matters, including the status of your request.
As new information about programs becomes available, Penn State representatives can call you with updates. If you do not wish to be contacted by phone for this purpose, please check "No." Calls about updates? Yes No
Applicant Information
Date of birth (mm/dd/yyyy):*

Gender:* Female Male
Are you a U.S. citizen?* Yes No
Are you a high school graduate?*
Yes; year graduated
No
State College (Penn State University Park)
 No, thanks