Request Participation in AR Delta Literacy Institute - University of Arkansas at Pine Bluff

School/Organization Participation – Arkansas Delta Literacy Institute

Use this form to request participation for your organization, school, student or student group in the Inaugural UAPB Arkansas Delta Literacy Institute on Wednesday, November 4, 2026. The information provided will help UAPB plan activities, seating, meals and event logistics. A member of the Institute team will follow up with your school/organization contact to confirm participation and provide any additional details as needed. Thank you.

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School/District/Organization Name(Required)

City/Community(Required)

Primary Contact's Name(Required)

First Last

Primary Contact's Title or Role(Required)

Primary Contact Email(Required)

Enter Email Confirm Email

Select Participant Levels Pre-K through Adults (Use Drop Down Menu for Options)(Required)

Estimated Number of Students(Required)

Estimated Number of Adults(Required)

Will your group remain for the provided box lunch?(Required)

YES

Accessibility/Accommodation Needs

Please provide details. Thank you.

Comments(Required)

Please provide any additional information you would like to share or questions. Thank you.

School/Organization/Parent Participation Confirmation

I confirm that I am authorized to submit this participation request on behalf of my school, student or student group.

Yes

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