CLA Interest Form

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CLA Interest Form

Thank you for your interest in services through Community Learning Academy. Please complete the form so we can better serve you.

How did you learn about Community Learning Academy

Facebook

Instagram

TikTok

Chamber of Commerce

Friend, family, co-worker, etc

Other:

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What is your name? *

What is your child's name? *

What is your child's age, grade, and school?

What Service Branch are you interested in? *

Community Learning Afterschool Academy: AUG-MAY 3:00-5:30 1st-6th

Community Early Learning Academy: AUG-MAY 12:00-3:00

Community Learning Lifeskills Summer Camp JUN-JUL 8:00-4:00

Special Education Consultation Services

Behavior Consultation Services

Required

Does your child currently have an IEP or 504 plan? *

Yes

Initial IEP/504 is in process of being created

Other:

What is your Email? *

What is your phone number? *

Please give a brief description of any needs or accommodations required for your child.

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