Literacy Programs

Family Literacy Registration Form

We are interested in signing up for the following session:

Kindergarten through 3rd Graders
Tuesdays
Starting January 5, 2010

Kindergarten through 3rd Graders
Wednesdays
Starting January 6, 2010

4th through 6th Graders and Continuing Participants
Thursdays
Starting January 7, 2010

Child’s Name:

Child’s Birthdate:

/ /

Child 2 Name:

Child’s Birthdate:

/ /

Child 3 Name:

Child’s Birthdate:

/ /

Parent 1 Name:

Parent 2 Name:

Address:

E-mail Address:

Phone Number

Cell Phone

What language do you speak? English Spanish Both

What school does your child go to?

You will receive a phone call from our staff to let you know if your enrollment has been accepted based on age of child and available space in each session.