OCC Tribal Cluster Meeting Registration Questions 6-21-24

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: