Chapter 510's Young Writer Sign-up Form (For Young Writers and Parents)
Are you a student or parent who would like to enroll yourself or your child/children in upcoming writing workshops, camps, or our free after-school tutoring program?

Fill out this form to receive enrollment information once we've launch programming here at our center.

Know that any East Bay student ages 8-18 can enroll in our free workshops and camps, but after-school tutoring is reserved for students enrolled in the Oakland Unified School District and are in financial and academic need.

If you would like to enroll more that one child, please fill out the form for each separately.

Full name of student (first and last) *
Your answer
Date of Birth *
Your answer
Grade *
Race/Ethnicity *
Zip code *
Your answer
Parent/Legal Guardian (full name)
Your answer
Student's Gender *
Student's email (optional)
Your answer
Student's phone number (optional)
Your answer
Parent's email *
Your answer
Parent's phone number *
Your answer
I am interested in the following opportunities at Chapter 510 (Check all that apply): *
Never submit passwords through Google Forms.
This form was created inside of Chapter510. Report Abuse - Terms of Service