2018 Summer Enrichment Program Student Application
Lilly Grove Missionary Baptist Church
Rev. Terry K. Anderson, Senior Pastor
Rev. Carlos Washington, Associate Pastor
By entering your email address above, you will receive a copy of the completed application.
Date of Birth
6 years old
7 years old
8 years old
9 years old
10 years old
11 years old
12 years old
13 years old
14 years old
School(s) Attended in 2017-18 School Year/Dates
Grade Level - August 2018
Select T-shirt/Polo-Style Size (Y=youth, A=Adult)
Our goal is to provide a positive and enriching experience for your child. You can help us by providing as much information as possible. Please give information about any special concerns, education modifications, and medical needs including: allergies, existing illnesses, previous serious illnesses, disabilities, continuous use of medication.
Is this the first year your child will participate in the Summer Enrichment Program (SEP)?
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