Literacy Programs

Family Literacy Registration Form

We are interested in signing up for the following session:

Kindergarten through 2nd Graders
(Session 1 Fully Registered)
Session 2:
Wed. Jan. 7, 2009 to Mar. 11, 2009
Session 3:
Wed. Mar. 25, 2009 to Jun. 3, 2009

3rd through 5th Graders
(Session 1 Fully Registered)
Session 2:
Thu. Jan. 8, 2009 to Mar. 5, 2009
Session 3:
Thu. Mar. 19. 2009 to Jun. 4, 2009

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.