2016-2017 Evening Programming Application
(To be used after Aug. 18th) You must fill out an application for EACH child
Parent FIRST Name *
Your answer
Parent LAST Name *
Your answer
Parent STREET Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Parent Email *
Your answer
Parent Phone Number *
Your answer
Student FIRST Name *
Your answer
Student LAST Name *
Your answer
Student School *
Your answer
Student Current Grade *
Ethnicity *
Returning? *
(Did this child participate last school year and/or this past summer?)
Receives Free or Reduced Lunch? *
(Not used for the selection process in any way)
Programs *
Select each program you are interested in for your child.
Required
If you are applying for Evening Tutoring, please tell us any specific subject your child is applying for.
Your answer
You will be notified by email of your acceptance status. If accepted, you will receive a packet no later than Aug. 22nd with details of our start date and documents you must bring to a Mandatory Parent Meeting.
Your answer
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