CalSAC's 10th Annual CA Afterschool Challenge Registration
May 12-13, 2014

CalSAC's 10th Annual CA Afterschool Challenge
May 12 - 13, 2014 ~ Sacramento, CA

The CA Afterschool Challenge aims to educate and inspire professionals, youth, and parents in afterschool and school-age care programs to engage in grassroots advocacy to advance the out-of-school time field.

This unique event, held each May, includes a full day of training and networking that culminates with legislative visits and a rally at the State Capitol. Training is provided for middle and high school youth, professionals and experienced advocates. Participants learn about the issues impacting the out-of-school time field as well as educate legislators about the importance of these vital afterschool and school-age care programs from their first hand experience.

Please complete one registration form per adult attendee. Registration is FREE.

Visit the CA Afterschool Challenge webpage for more event details - https://calsac.org/get_involved/advocacy.

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* 1. First Name:

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* 2. Last Name:

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* 3. Organization Name:

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* 4. Title at Organization:

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* 5. Home Phone Number: (xxx-xxx-xxxx)

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* 6. Work Phone Number:

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* 7. Cell Phone Number:

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* 8. Email Address:

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* 9. Home Address:

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* 10. City:

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* 11. State:

Other

If other (please specify)

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* 12. Zip Code:

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* 13. Work Address:

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* 14. City:

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* 15. State:

Other

If other (please specify)

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* 16. Have you attended the CA Afterschool Challenge in the past?

Yes

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* 17. Which of the following would you consider yourself to be?

I currently or have in the past worked in the policy field

I am an experienced advocate (knowledgeable and comfortable with the legislative process, OST policy and visits with legislators)

I am an emerging advocate (limited to no experience with the legislative process\, OST policy and legislative visits)

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* 18. What days will you be attending?

Monday and Tuesday (May 12 & 13)

Monday only (May 12)

Tuesday only (May 13)

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* 19. Program Type (check all that apply):

School-based Afterschool (Public and/or Private funding)

School-based Child/School-Age Care (Public and/or Private funding)

Community Based Organization

Licensed Family Child Care

Boys and Girls Club

Park and Rec

YMCA

Girl's Inc.

4-H Council

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* 20. Population Served (check all that apply):

K - 2nd Grade

3rd - 5th Grade

6th - 8th Grade/Middle School

9th - 12th Grade/High School

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* 21. Do you require a vegetarian meal?

Yes

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* 22. Would you like to be a legislative visit Team Leader?

Yes

Maybe - send me more information

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* 23. Are you registering youth?

Yes