Ready, Set, Learn! Tri-Cities area

0-5 Parent Outreach in partnership with

ETSU Department of Audiology and Speech Pathology

invite you to their

Ready, Set, Learn! parent workshop.

February 9th 2:00-4:00 pm

Childcare available

ETSU: The Nave Center
1000 Jason Witten Way
Elizabethton, TN 37643

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* 1. Please provide your contact information:

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Child's name

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* 3. Child's age

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* 4. Describe your child's hearing concern/loss

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* 5. We will have childcare provided. Will you need childcare?

I will need childcare

I will not need childcare.

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* 6. If you will need childcare, please list name and ages of children in childcare.

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* 7. Information about my child in childcare that I want the caregivers to know.

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* 8. I will need an interpreter.

Yes, I need an ASL interpreter.

Yes, I need a Spanish interpreter.

I do not need an interpreter.

Other

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* 1. Please provide your contact information:

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* 2. Child's name

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* 3. Child's age

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* 4. Describe your child's hearing concern/loss

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* 5. We will have childcare provided. Will you need childcare?

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* 6. If you will need childcare, please list name and ages of children in childcare.

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* 7. Information about my child in childcare that I want the caregivers to know.

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* 8. I will need an interpreter.

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* 9. How did you hear about our parent workshop?