Whitefield Library Family Village Registration

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* 1. Please enter your full name

First Name

Last Name

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* 2. Please enter your email address

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* 3. Please enter your telephone number

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* 4. What mode of communication do you prefer

Email

Phone Call

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* 5. What School(s) does your student(s) attend? Please check all that apply

Whitefield Elementary School

Lancaster Elementary School

White Mountain Regional High School

Other (please specify)

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* 6. Would you be interested in volunteering for/training to lead Family Village activities?

Yes

No

Maybe

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* 7. Do you have any questions about Family Villages?

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* 8. Are you in need of childcare to attend the family village sessions?

Yes

No

Other (please specify)

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* 9. If you answered yes to needing childcare, please tell me how many children you need care for and their ages.