DTYCTS Event Registration Form

What is the name of your school/organization




Zip Code

What type of organization do you represent
(check all that apply)
Elementary School
Middle or Junior High School
High School
Head Start of Early Start
Community Based Organization

School/Organizaion phone number (xxx-xxx-xxxx)

Contact person's full name

Contact person's title

Contact person's direct phone number (xxx-xxx-xxxx)

Contact person's email

I would like help setting up my event

What is the best way to follow-up with you

Would you like to be added to the email list to get more information regarding fatherhood programs