Manatee Literacy Council · Learner Interest and Registration

Contact Information

Name

*

Prefix

First Name

Last Name

Suffix

Name you prefer to be called / Nickname

Email (primary/main)

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Verify Email

*

Email (secondary)

Verify Email

Phone (primary/main)

*

Phone (secondary)

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Native Language (Mother Tongue)

Registration Fee

$20 - One-time fee

Learner Responsibilities

I understand that I need to contact Manatee Literacy Council if my ability to attend classes or meet with my tutor changes. I know that if I have 3 unexcused absences from attending the class/classes that I am enrolled in, I risk losing my services.

I understand that the staff and volunteers of the Manatee Literacy Council will make every effort to reach me. They may try to reach me by phone, email, texting, or WhatsApp. Failure to respond may result in being dropped from MLC's programs.

I also understand that I must follow the "House Rules" outlined below. Failure to comply may result in my being dropped from all future services.

Learner Agreement

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I have read the learner responsibilities and will abide by the 'House Rules'

I disagree with learner responsibilities and will not abide by the 'House Rules'.

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.

Do you agree with the above photo release?

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Yes, I give my full permission to Manatee Literacy Council to utilize my photographs and/or statements.

No, I do NOT give permission to utilize my photographs and/or statements.

Please type your name or initials for photo release agreement.

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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.