Afterschool Alliance :: Lights On Registration 2010

Register for Lights On Afterschool 2012!

Contact Information

Salutation:
*First Name:
*Last Name:
Title:
*Email:
W. Phone:
Fax:
*Program/Org.:
*Program Address:
*City: *State: * Zip:
Website: (please use the form " http://www.yoursite.org ")

Tell us how you're celebrating Lights On Afterschool

Include as much information as possible; your celebration will be promoted on our Find an Event section, which is shared with media and the public. Your information will also be used to generate an event flyer for your use that you can download from your event entry in the Find an Event section 7-10 days after submitting your registration.

Are you registering events for multiple sites? Enter the number of additional events and we will contact you to collect the site information.

I plan to celebrate Lights On Afterschool by:

Use the text field to provide additional event details.

When are you having your Lights On celebration?

Date: Time: [start]-[end]

Upload a photo of your program or your event invitation to be included in your description and flyer (PDF, .gif, .jpeg files are best)

Upload:

Including youth program participants, the number of guests we are expecting at our event is:

National Affiliation:

If "Other", please specify:

We plan to invite: (select all that apply, use Ctrl to multi-select)

Is there a particular VIP invited we should know about?

Tell us about your program:

We'd love to learn more about your program. The information you provide will help us to better serve you and the entire afterschool field, while also helping us to make the case for afterschool for all on Capitol Hill.

Select the types of activities your program offers: (select all that apply, use Ctrl to multi-select)

Number of years program has been operating:

Number of students in program:

Where did you hear about Lights On Afterschool?

If "Outside organization", please specify:

*-It takes a moment for your registration to be processed, so please do not click the button more than once. A confirmation email will arrive in your mailbox shortly. Thank you!