First name*
 
 
 
 
Last name*
 
 
 
 
Email*
 
 
 
 
Phone Number*
 
 
 
 
Preferred Contact Method (select all that apply)*
 
 
 
County*
 
 
 
 
ZIP Code*
 
 
 
 
How many children in your household will be entering first through 10th grade in the fall of 2026?
 
 
 
 
Which grade(s) will your children be entering in the fall of 2026? Please select all that apply.
 
 
 
Optional: Questions/comments
 
 
 
 
I agree to United Way’s terms and conditions (click the link below to read more) and that United Way and other Summer Discovery partner and provider organizations may contact me about Summer Discovery and other opportunities.*
 
 
 
 

UnitedWaySEM.org/about-us/policies