Baby Raven Reads Enrollment
Baby Raven Reads is a program that promotes language development and kindergarten readiness for Alaska Native families with children up to 5 years old or who are not yet enrolled in kindergarten.

A separate form must be completed for each child enrolled in the program.

Responses on this form will be kept confidential and used only for program purposes.

Limited space available--completion of this form does not guarantee placement in the program.
This form is the first part of a two part enrollment process. In the second stage of enrollment, selected families will be contacted to complete an initial Reading Attitudes Survey.

Child's last name *
Your answer
Child's first name *
Your answer
Child's age *
Your answer
Child's date of birth *
Child's gender *
Estimated graduation date from Raven Reads program (date child will enter kindergarten) *
Mailing Address (PO box or street name and number) *
Your answer
City *
Zip Code *
Your answer
Primary contact's email address *
Your answer
Primary contact's phone number *
Your answer
Primary contact's last name (parent/guardian) *
Your answer
Primary contact's first name (parent/guardian) *
Your answer
Child's tribal affiliation *
In the past week, what is your best estimate of how many minutes per day anyone in your household read to each child/children enrolled in the Baby Raven Reads Program?
Your answer
How often does your child engage in the following behaviors? *
Most of the time
Don't Know
Asks to be read to
Pays attention while being read to
Participates positively in group activities
Remembers and connects experiences
Recognizes letters and symbols
Uses words or gestures to communicate their wants or needs
Follows basic directions
Uses Lingít, X̱aad Kíl or Sm'algya̱x language
Voluntary information; Is your child enrolled in:
Is your child a current Baby Raven Reads participant?
Are you interested in being a parent helper in your community? *
Participation agreement *
Baby Raven Reads requires participation from those enrolled in the program for events and surveys.
I agree to participate in Baby Raven Reads:
Program events
Reading attitude surveys
Program feedback surveys
Kindergarten readiness assessments
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