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Woodlynde School Summer Program
June 25-July 20 Application for those entering into Grades 6th to 8th
Email address *
Student's Name (First & Last): *
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Student's Nickname:
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Student's Gender: *
Parent A Name: *
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Parent A Address *
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Parent A City, State, Zip Code *
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Parent A Home Phone Number: *
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Parent A Cell Phone Number: *
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Parent A Work Phone Number:
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Parent B Name:
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Parent B Address:
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Parent B City, State, Zip Code
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Parent B Home Phone Number:
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Parent B Cell Phone Number:
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Parent B Work Phone Number:
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Who does the applicant live with? *
Student's Date of Birth: *
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Student's Age as of 06/01/2018: *
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Current School: *
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Current Grade and Teacher: *
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Strengths and areas of need that affect this child's learning and social interactions: *
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Has your child attended the Woodlynde School Summer Program before? *
If yes, what year(s):
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Program Options for Students Entering Grades 6th to 8th: *
T-shirt size: *
Would you like to be included in our carpooling information? *
How did you hear about Woodlynde School's Summer Program?
Thank you for taking the time to complete the application for the Woodlynde School Summer Program.
Please click SUBMIT to ensure your application gets turned in. There is an application fee of 10%. Please make a check payable to Woodlynde School and send it to: Woodlynde School Summer Programs, 445 Upper Gulph Road, Strafford, PA 19087. Jessica Sicina or Kelly Price will contact you soon for a time to assess your student for proper placement during the summer program. Once your student has been accepted an invoice will be sent out in early spring.
A copy of your responses will be emailed to the address you provided.
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