Family Resource Fair

1

Parent / Guardian Name* This field is required.

First Name

Last Name

2

Parent / Guardian Email* This field is required.

example@example.com

3

Parent / Guardian Phone Number

Area Code

Phone Number

4

Co-Parent / Guardian Name

First Name

Last Name

6

County you currently reside?* This field is required.

New Castle

Kent

Sussex

7

Zip Code* This field is required.

8

Marital Status* This field is required.

Not Married

Married

Other

9

Please select what best describes your race or family background:* This field is required.

African American

American Indian/Alaskan Native

Caucasian

Hispanic

Asian

Other

10

If other please state:

11

Number of children * This field is required.

12

Children Age(s):

13

Overall, how many children do you have?

14

What is your connection with the father/mother of your child(ren)?

I am married to the father/mother of my child(ren)

I am engaged to the father/mother of my child(ren)

I am in a relationship with the father/mother of my child(ren)

I am co-parenting with the father/mother of my child(ren)

Other:

15

If other explain:

17

If other please explain: