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Deaf & Hard of Hearing Family Night
Date: Wednesday, February 12th from 5:30-7:45 p.m.
Location: Four Seasons Elementary School, 318 Moore St, Saint Paul, MN 55104
(Please enter main doors on Moore St.)
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Name of parent/guardian attending:
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# of adults attending:
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Phone number:
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Email:
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Student name:
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Student's school:
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Do you need childcare to attend:
Yes
No
Does your child have special needs that childcare staff need to be aware of?
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Ages of children needing childcare:
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Interpretation requested:
Hmong
Karen
Somali
Spanish
Sign Language
Other:
For Sign Language interpreter please share who the deaf consumer is:
Parent
Elementary aged student (K - 5th grade)
Secondary aged student (6th grade - High School)
Focus Beyond student
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