Skip to content
Passport to Literacy Registration
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?
(Required.)
*
2.
What is your last name?
(Required.)
*
3.
How many adults will attend with you?
(Required.)
*
4.
How many children will attend with you?
(Required.)
*
5.
Please mark the age group of each child attending. ****We must know this information to plan for child care.
(Required.)
Infant up to 2 years old
2 years up to 4 years old
4 years up to 6 years old
6 years up to 8 years old
8 years and older
*
6.
Do you have one or more children with an IEP or an IFSP (SoonerStart)?
(Required.)
IEP (Individualized Education Plan)
IFSP (Individualized Family Service Plan, with SoonerStart)
Neither
Not sure
*
7.
How did you hear about this event?
(Required.)
Community poster/flyer (such as at the library)
Organizational contact
Facebook or email
Friend/family member
My child's teacher. Please share his or her name:
*
8.
What is your preferred phone number?
(Required.)
9.
What is an alternative phone number?
*
10.
What is your email address?
(Required.)
*
11.
What is your mailing address?
(Required.)
*
12.
Please mark your gender.
(Required.)
Male
Female
Prefer not to answer
*
13.
Please mark your ethnicity.
(Required.)
Caucasian/White
Hispanic or Latino
African-American/Black
American Indian/Native American/Alaskan Native
Asian
Native Hawaiian/Pacific Islander
Two or more races
Prefer not to disclose my ethnicity
*
14.
Is English your primary language?
(Required.)
Yes
No. Which language is your strongest?
*
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.
(Required.)
Yes
No
Not sure
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.