SEAC - January 14, 2019 - Free Child Care Sign Up Form (Sign up by Friday Jan. 11)
The Jackson School District Special Education Advisory Committee (SEAC) is sponsoring a workshop on Monday, Jan. 14, 2019 at Jackson Liberty High School's IMC (library).
6:30 – 8:00 p.m. Life After School
Use this form to sign up for our FREE child care at this location so you can focus on the workshops. All child care will be provided by Jackson School District staff members. This form will close on Jan. 11, 2018.
First Name of Parent/Guardian
Last Name of Parent/Guardian
Number of CHILDREN attending who need child care services
Please tell us the number of children attending.
How old is the child who will be attending? Check all that apply.
1 or younger
10 or older
Contact phone number
Please list the best number to contact you, with area code.
Contact e-mail address
Please list the best e-mail address to contact you.
Please us this area to let us know if there are any special needs or accommodations your child will need during his/her time with us during this event?
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