GEM Talk & Reading Series
Oct 25th - Nov 15th, Wednesdays, 6:00 PM - 7:30 PM
Who will join this reading club?
*
One Parent
Two Parents
Child(ren)
No of Child(ren)
Please Select
1
2
3
4
Parent Full Name
*
First Name
Last Name
Parent Email
*
example@example.com
Parent Phone Number
*
Please enter a valid phone number.
Second Parent's Name
*
First Name
Last Name
Second Parent's Email
*
example@example.com
Second Parent's Email
*
Please enter a valid phone number.
1- Student Name
First Name
Last Name
1- Grade
Please Select
K
1
2
3
4
5
6
7
8
9
10
11
12
2- Student Name
First Name
Last Name
2- Grade
Please Select
K
1
2
3
4
5
6
7
8
9
10
11
12
3- Student Name
First Name
Last Name
3- Grade
Please Select
K
1
2
3
4
5
6
7
8
9
10
11
12
4- Student Name
First Name
Last Name
4- Grade
Please Select
K
1
2
3
4
5
6
7
8
9
10
11
12
Select all that apply
*
I volunteer to speak for 5-10 minutes.
My child volunteers to speak for 5-10 minutes.
I am a reading participant and a listener of GEM Talks.
I (Parent) will speak on a topic of my choice on this day:
*
10/25
11/1
11/8
11/15
My child will speak on a topic of her/his choice on this day:
*
10/25
11/1
11/8
11/15
Select all that applies to you
*
Parent of Elementary Student
Parent of Middle School Student
Parent of High School Student
How did you hear about this program?
*
Facebook
Email
Whatsapp
Friend
Word of Mouth
Attended previous event at GEM
Other
Submit
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