Please answer all the information below so we can register you for the Passport to Literacy event.

The event will be held September 16 at 9:00am at the Wilson Learning Academy in Tulsa.

Thank you!

* 1. What is your first name?

* 2. What is your last name?

* 3. How many adults will attend with you?

* 4. How many children will attend with you?

* 5. Please mark the age group of each child attending. ****We must know this information to plan for child care.

* 6. Do you have one or more children with an IEP or an IFSP (SoonerStart)?

* 7. How did you hear about this event?

* 8. What is your preferred phone number?

* 9. What is an alternative phone number?

* 10. What is your email address?

* 11. What is your mailing address?

* 12. Please mark your gender.

* 13. Please mark your ethnicity.

* 14. Is English your primary language?

* 15. Do you need help with transportation to the event? If you mark yes, we will contact you about providing one or more bus passes for Tulsa Transit.

* 16. Please list any special accommodations below:

Translators/interpreters, sign interpreters, special meal requirements, and/or other special accommodations will be available upon advance request (please allow a two week notice).  Any requests made after September 5, 2017, may not be available. 

For more information, call 1-877-553-4332 or email lcoats@oklahomaparentscenter.org.

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