2019-20 SMCS Program of After School Enrichment (PASE) Drop-In Request Form
This form is used to request a SMCS student participate, as a Drop-In, for our Program of After School Enrichment.
This form is for any current SMCS student.

It is helpful to also email:
pase@stmarystaylor.org and the students teacher.
Calling the school office is requested to ensure the form and email request was received.

* Sign out is required from RM-303, our Resource Lab.
* Please use the Northeast Gym / PASE Entrance.
* Payment is not required or accepted at the time of participation.
* Your FACTS account will be billed $12, per student, for participation in this as needed service, when communicated.

Email address *
Student's First Name *
Your answer
Student's Last Name *
Your answer
What is your students grade for the 2019-20 school year? *
What day do you need your student to be a Drop-In? *
I understand the 2019-20 St. Mary's Catholic School's Program of After School Enrichment Guide and agree to follow the policies and procedures therein. I also am aware of the fee structure and FACTS billing that will be applied to my account. (Enter the name of the person completing this form below.) *
Your answer
A copy of your responses will be emailed to the address you provided.
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