Hidden Fields Section Template - Use this section to enter default values for each event registration. These values will get mapped back to the enrollment records in Salesforce.

Program ID

Enrollment Record Type ID

Start Date

Status

Work Email

Personal Email

Work Phone Number

Home Phone Number

Mobile Phone Number

Who's attending?

Your first name:

Your last name:

Your email type:

WorkPersonal

Your email address:

Your phone number type:

WorkHomeMobile

Your phone number:

Your ZIP code:

About your organization

Organization name:

Organization website:

How are you involved with this organization?

On the staffAs a volunteerOther

How are you involved with this organization (other)?

Your job or volunteer title:

What program are you most involved with at this organization? (ex: ESL, Family Literacy etc.)

Your needs on the day of the event

Do you need any special accommodations?

NoYes

Please describe the accommodations you need

Breakfast and lunch will be provided at the symposium. If available, what type of meal do you prefer?

Gluten-freeVegetarianNo food restrictions

Must be checked to proceed

I understand that photos and videos will be taken at the symposium and may be used for training or other purposes by Literacy Texas or their partner agencies.

Once you submit, you’ll receive a confirmation message. Please check your spam if you don’t see it, and if it doesn’t arrive at all, get in touch. Use info@literacytexas.org for any questions about the symposium. Thank you!

Contact Information