Ounce of Prevention Fund: Ounce of Prevention Fund: Registration

Please provide your HOME address so that we can connect you to your elected representatives.

If you work for an early childhood provider, please tell us your organization's name in the Employer field below.

Registration Information:

If you have previously registered, please login here to prepopulate your information.

Name:

Title	First Required	Middle Required	Last Required	Suffix

Email: Required

Street 1: Required

Street 2:

City/State/ZIP:

City Required	State Required	ZIP Required

Country: Required

Phone Number:

Employer:

Yes, I would like to receive e-mail from Ounce of Prevention Fund

Yes, I would like to receive postal mail from Ounce of Prevention Fund

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Please enter a user name and password for logging in when you return. You can use this password to update your information or receive personalized content.

*	User Name: Required	5 to 60 characters
*	Password: Required	5 to 20 characters
*	Repeat Password: Required

Question - Not Required - To receive updates from the Ounce, please sign up for our Early Edition e-newsletter and Action Alerts.

Yes, I would like to receive Early Edition and Action Alerts

Question - Not Required - Please select all topic areas you are interested in. We will occasionally send out alerts and information based on specific topics.

	Child Care
	Disabilities
	Early Childhood Mental Health
	Head Start/Early Head Start
	Health
	Home Visitation/Parent Coaching
	Infants and Toddlers
	Preschool
	Professional Development

*4.

Question - Required - Occupation (check all that apply):

	Parent
	Teacher
	Early Childhood Provider
	Student
	Other Early Childhood Provider (i.e. health, mental health, disabilities)
	Advocate
	Legislator, Legislative Staff
	Other

Question - Not Required - If you chose Other in the question above, please describe.

33 W. Monroe, Suite 2400 | Chicago, IL 60603 | 312.922.3863