Office of Child Care Tribal Cluster Meeting Registration Questions

Administration for Children and Families Generic for Information Collections related to Gatherings

OCC Tribal Cluster Meeting Registration Questions 6-21-24

Office of Child Care Tribal Cluster Meeting Registration Questions

OMB: 0970-0617

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OMB Control Number: 0970-0617

Expiration date: 09/30/2026

Office of Child Care Tribal Cluster Meeting: Registration Questions

All fields followed by * are required.

Please select your role at this event. * (drop down list)

  • Tribal CCDF Administrator

  • Tribal CCDF Lead Agency Staff

  • Tribal Fiscal Staff

  • Federal Employee

  • OCC National Center TA Staff (drop down list)

    • 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)

    • Tribal Child Care Capacity Building Center (TCBC)

    • Tribal Child Care Program Support Center (TPSC)

  • Invited Presenter or Guest

  • Other

    • Please specify ______________



Contact Information

  • First Name *

  • Last Name *

  • Title/Position *

  • Organization or Tribe/Tribal Organization *

  • City *

  • State *

  • Zip Code*

  • Telephone Number *

  • Email Address *

  • OCC Region * (drop down list)

      • Region 1 (CT, MA, ME, NH, RI, VT)

      • Region 2 (NJ, NY, PR, VI)

      • Region 3 (DC, DE, 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, OK, NM, 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)

      • N/A



Are you a Public Law 102-477 Grantee?

☐ Yes

☐ No

☐ Unsure



Do you require any special accommodations?

☐ Yes

Please specify ______________

☐ No



Will you be staying at the meeting hotel?

☐ Yes

☐ No

☐ Unsure



Emergency Contact Information

Emergency Contact Name:

Emergency Contact Telephone Number:

Emergency Contact Email Address:

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorCassell, Stacy (ACF)
File Modified0000-00-00
File Created2024-11-13

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