Registration

OMB Control Number: 0970-0617 Expiration date: 09/30/2026

Please select your role at this event.

Role*

--------- Federal Employee State CCDF Administrator Territory CCDF Administrator State CCDF Staff Member Territory CCDF Staff Member OCC National Center TA Staff 21st Century Community Learning Center State Coordinator State Afterschool Network Lead Invited Presenter or Guest Other

Sub Role

--------- Child Care Automated Reporting System (CARS) Child Care Meeting Management Center (CMC) Child Care State Capacity Building Center (SCBC) Data and Information Systems Consultation Center (DISCC) National Center on Afterschool and Summer Enrichment (NCASE) National Center on Early Childhood Quality Assurance (NCECQA) National Center on Subsidy Innovation and Accountability (NCSIA) National Early Care and Education Workforce Center (ECE Workforce Center) National TA Center for Preschool Development Grants Birth through Five (PDG B-5 Center) Tribal Child Care Capacity Building Center (TCBC) Other

Other Role

Other Sub Role

Contact Information

First Name*

Last Name*

Prefix

--------- Dr. Mr. Mrs. Ms.

Title*

Division/Department*

Organization*

City*

State*

--------- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Guam Northern Mariana Islands Puerto Rico Virgin Islands

Zip code*

Phone number*

Email*

Emergency contact name

Emergency contact phone number

Emergency contact email

OCC Region*

--------- Region 1 (CT, ME, MA, NH, RI, VT) Region 2 (NJ, NY, PR, VI) Region 3 (DE, DC, MD, PA, VA, WV) Region 4 (AL, FL, GA, KY, MS, NC, SC, TN) Region 5 (IL, IN, MI, MN, OH, WI) Region 6 (AR, LA, NM, OK, TX) Region 7 (IA, KS, MO, NE) Region 8 (CO, MT, ND, SD, UT, WY) Region 9 (AS, AZ, CA, GU, HI, MP, NV) Region 10 (AK, ID, OR, WA) NA

Do you require any special accommodations?

--------- Yes No

Please specify.

0

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to collect registration information from potential participants in OCC’s School-Age Child Care Institute to allow organizers to compile proper resources and tools for participants. Public reporting burden for this collection of information is estimated to average 5 minutes per grantee, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This collection of information is voluntary. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0617 and the expiration date is 09/30/2026. If you have any comments on this collection of information, please contact stacy.cassell@acf.hhs.gov.