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Littlestown PROSPER

Strengthening Families Program Registration Information

Family Name ________________________________
Parentís Name(s):_________________________ , ____________________________ - (for name tags)

Studentís Name:_________________________, _________________________, _____________________


Phone: Home ______________Work _______________†† Email_______________

Which session would you attend:

Tuesday's Session will start January 27th and end on March 10th, 2009

Dinner 6:00PM Sessions 6:30PM to 8:30PM

Yes, our family will eat dinner at the program site.Number for meal planning____