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D23 Presidents Council, DPAC & Stop Hiding Inc Registration Form
Please complete form below to register for our event on November 19, 2022 11:00 AM -1:00 PM at
CSD 23 - District Office
CSD 23 - District Office
(Community School District 23 Office - Parent Resource Center)
1784 Park Place, Brooklyn NY 11233.
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Name (First & Last)
Name (First & Last)
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Address
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Zipcode
Zipcode
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Email
Email
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Please confirm what group you belong to
Please confirm what group you belong to
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Student
Parent
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Mobile Number
Mobile Number
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For those who selected “Other” above please give details
For those who selected “Other” above please give details
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How many children do you have?
(For parents)
How many children do you have?
(For parents)
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1
2
3
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5
6
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Age of children
Age of children
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0-5
5-10
10-15
15-20
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For students over 13 years old, please share your age [STUDENTS UNDER 13 REQUIRE PARENTAL CONSENT] PLEASE NOTE: Parent consents will be provided upon arrival at the registration desk.
For students over 13 years old, please share your age [STUDENTS UNDER 13 REQUIRE PARENTAL CONSENT] PLEASE NOTE: Parent consents will be provided upon arrival at the registration desk.
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Name of School(s)
Name of School(s)
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