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Contact Information
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Prefix
First Name
Last Name
Suffix

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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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Enter the month, day and year you were born

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Please select the current grade of each child.
Employment
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Please enter reason for conviction
Education
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(1-reads well, 5-average reader, 10-reads few words)
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(1-writes well, 10-very limited writing)
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Please be specific
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Please be specific
Availability and Location Information
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We offer free conversation classes for adult residents of Manatee throughout the week on Zoom. ($10/month for non-residents)

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Please note: MLC is collecting this information for the sole purpose of matching learners and tutors.
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Note: We NEVER sell or share your email or address.
Photo Release

I understand that my photographs and/or statements will be used in Manatee Literacy Council materials, which may be social media posts, website testimonials, newspaper articles, brochures, educational leaflets, funding requests to donors, annual reports, videos, and other related publications. I understand that this permission is valid indefinitely unless I notify the Manatee Literacy Council otherwise. 

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If you are a Manatee county resident and unable to pay the $20 registration fee, please contact our office (941-746-8197)

Payment Info
* You will NOT need a paypal account to pay by credit card. Press the yellow Paypal button on the next page and you will then be allowed to enter a credit card number to complete your application.  Paypal is our payment processor and can process credit cards.