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Summer Survey
The Raymond Central Before and After School Program through Civic Nebraska is developing a summer program and needs your input to decide what the program will look like! We cannot operate without the support of community members like you.

Details such as program site, schedule and cost are being evaluated and will depend upon interest and participation. Please send additional feedback or questions to Kara Nelson at kara.nelson@civicnebraska.org.
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Email *
Parent Name(s) *
Student(s) Name and Grade (enter each child's full name and grade for the 21-22 school year) *
Would you be interested in a summer program for your student(s). *
What is the primary reason you would be interested in having your child participate in this new summer program? Select all that may apply. *
Required
If so, what hours would be most beneficial? Select all that apply.
What interests does your student enjoy? Select all that may apply. *
Required
We would like to plan a field trip for each week. Do you have suggestions that kids might enjoy?
Would you or anyone you know like to volunteer in our summer program?
Do you or someone that you know have an interest and/or talent that they could share with kids?
Mother's Phone Number *
Father's Phone Number *
Will your child need any special accommodations? This may include dietary restrictions or behavioral or disability accommodations.
Additional information you would like us to know.
A copy of your responses will be emailed to the address you provided.
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