OSSE Parent and Family Engagement Conference Registration  

Saturday, September 22, 2012 - 9:00 am to 2:00 pm

Walter E. Washington Convention Center  

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1. Pre-Conference Registration

Pre-Conference Registration   Parent Last Name
Parent First Name
Name of School(s) Your Children Attend
Title/Organization (not applicable to parents)
Phone
Email

2. How did you hear about the Parent and Family Engagement Conference?

How did you hear about the Parent and Family Engagement Conference?

3. Will your child(ren) attend with you?

Will your child(ren) attend with you?   Yes No

4. How many children will attend with you?

How many children will attend with you?

5. What is your child(ren)'s current grade level(s)? (check all that apply):

What is your child(ren)'s current grade level(s)? (check all that apply):   Pre Kindergarten - 1st Grade 2nd Grade - 3rd Grade 4th Grade - 6th Grade Middle School High School

6. Is your child(ren) currently attending a 21st Century Community Learning Centers program?

Is your child(ren) currently attending a 21st Century Community Learning Centers program?   Yes No

7. If yes, which 21st Century Community Learning Centers program does your child(ren) attend?

If yes, which 21st Century Community Learning Centers program does your child(ren) attend?   Achieve Tutoring AFC Scholarship Foundation, Inc. Beacon House City Gate, Inc. City Kids DC Scholars Public Charter School District of Columbia Public Schools (DCPS) Elsie Whitlow Stokes PCS Friendship Public Charter School Higher Achievement Program Horton's Kids LifeSTARTS Youth & Family Services Metropolitan Day School New Community for Children Paxen Learning Corporation People Animals Love Sasha Bruce Youthwork, Inc. Save the Children, Inc. The Fishing School The Literacy Lab The SEED School of Washington, DC Thurgood Marshall Academy Public Charter High School YOUR Community Center Not sure

8. I am interested in (check all that apply):

I am interested in (check all that apply):   Bullying Prevention Disciplinary Policy New State Report Card for Schools Impact of the New Education Plan on my School How Schools are Classified Access to Early Childhood Afterschool Programs Access to Higher Education Special Education Services Transportation Adult Education Services for Families in Transitory Housing (Homeless Families) Strategies to Help my Child Succeed in School Wellness and Nutrition Athletics

9. Please check any of the services below that you would like to receive:

Please check any of the services below that you would like to receive:   Spanish Interpretation Amharic Interpretation American Sign Language