ConnCAT Summer Program Application 2020
We are excited to have both new and returning children join us for another series of fun special arts workshops and field trips!
Please note that there will be a $50 required non-refundable registration fee for EACH ADMITTED APPLICANT. DO NOT REMIT ANY MONIES UNTIL YOU RECEIVE AN ACCEPTANCE RESPONSE.


- Program Dates: July 6 - August 14 2020 (*Program dates are contingent upon social distancing protocols).
- Hours: Mon - Fri 10:00 am-4:00 pm
- Parents must arrange transportation for drop-off/pick-up

- Parents/Guardians must submit 1 application PER CHILD.

- Our program heavily relies on text and email to contact parents. Please provide us with ACTIVE phone numbers and/or email addresses that you check regularly.

- Please click on "SUBMIT" at the very end of the online form to ensure delivery.

*APPLICATION DEADLINE: MAY 29, 2020 BY 5PM. Parents will be notified via email of their acceptance status by June 5, 2020. Late applications will be place on a Wait-List.

*Understanding current events regarding the COVID-19 virus, ConnCAT may adjust deadline dates accordingly if deemed necessary.

Questions? Contact Steve Driffin (; Kelaiah Lawrence (; Stephanie Mallard (
HOUSING CODE. This question is for specific applicants ONLY. If you have been provided with a Housing Code from HANH, please enter the code below.
Your answer
Child Last Name *
Your answer
Child First Name *
Your answer
Address *
Street, Unit, City, State, Zip
Your answer
Grade *
Untitled Title
Age *
Your answer
School Name *
Your answer
Date of Birth (Please manually enter the year) *
Gender *
T-Shirt Size *
Does your child have a sibling applying for the Summer 2020 Program? *
If your answer is YES, please type their sibling's name(s) in the space provided. A separate application MUST be completed for each child.
Sibling Name(s)
Your answer
Do you consider your child to be Hispanic or Latino?
How did you first hear about ConnCAT Youth Programs? *
Parent 1 Last Name *
Your answer
Parent 1 First Name *
Your answer
Parent 1 Street Address *
Street and (Unit #)
City *
Zip Code *
Your answer
Parent 1 Cell Phone Number (Example: (203) 111-1111) *
Your answer
Parent 1 Daytime Phone Number (Example: (203) 111-1111) *
Your answer
Parent 1 Email Address *
Your answer
Would you like to receive text notifications for emergencies/occasional updates? *
Remind 101 is a free text message system and is our primary form of mass communication during the summer program. You will NOT be enrolled automatically, but will need to follow a set of instructions on your phone to be enrolled once your child has been admitted to the program. This is MANDATORY for ALL accepted parents.
Parent 2 Last Name
Your answer
Parent 2 First Name
Your answer
Parent 2 Cellphone Number (Example: (203) 111-1111)
Your answer
Parent 2 Daytime Phone Number (Example: (203) 111-1111)
Your answer
Parent 2 Street Address
Street and (Unit#)
Your answer
Your answer
Your answer
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