2020-2021 LMS After-School Program
Students will attend Monday, Tuesday and Thursday, Friday weekly from 3:30 - 5:30 at Jefferson Elementary and be placed on a first come, first serve basis. / Los estudiantes asistirán los lunes, martes y jueves, viernes semanalmente de 3:30 a 5:30 en Jefferson Elementary y serán asignados por orden de llegada.
Email address *
Student First Name / Primero Nombre de estudiante *
Student Last Name / Apellido Nombre de estudiante *
2020-2021 Student Grade Level / Grado del estudiante *
Parent(s) Name / Nombre de Padre(s) *
Parent(s) Mailing Address / Direccion de Padre(s) *
Parent(s) Telphone(s) / Telefono de Padre(s) *
Does you child have allergies? / Tiene alergias? *
If yes to above, please explain ? Si, por favor explique:
Bus student / estudiante de autobus? *
If yes, Bus Pick-up Location / Si, Lugar de recogida del autobus.
Emergency Contact Name and PhoneNumber / Contacto Emergencia Nombre and Numero de Telefono *
A copy of your responses will be emailed to the address you provided.
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