After School Care at Ginsburg Elementary
Welcome to ASC at Ginsburg!

End each day with trusted care by a highly qualified, trained staff. Students will have a snack, be assisted with homework, have free play time outdoors (weather permitting), and structured enrichment activities.

Hours: Monday-Friday 2:45pm - 5:45pm
Sign in to Google to save your progress. Learn more
Child Information
Child's Name *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Allergies/Medications
Start Date for After School Care *
MM
/
DD
/
YYYY
Parent Information
Primary Contact Name *
Address *
Please include Street, City, State and Zip
Home Phone
Work Phone
Cell Phone
Email
Secondary Contact Name *
Address (if different)
Home Phone
Work Phone
Cell Phone
Email
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Chicago Public Schools.

Does this form look suspicious? Report

Google Forms