Kindergarten Readiness Summit - Pre-registration
RequiredRequired Question(s)
1.
Please enter the information indicated below.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

Required 2.

Please select the item that best describes your interest in attending the Kindergarten Readiness Summit:

Parent/grand parent
Family leader
Child care provider
Educator
Community activist
Political leader
Public administrator
Community-based organization
Religious institution/Faith-bas-
ed organization
Other  
  • Comment:

  • 500 characters left.
Required 3.

Would you need childcare service at the Summit?

Yes
No
4.

If you check "Yes" above, how many children (12 years and under) will attend with you? 

 

50 characters left.
5.
What do you think our community (parents, child care providers, policy makers & others) can do differently to help west Louisville children be kindergarten ready?
 

1000 characters left.
6.
Other comments?
 

350 characters left.