Chess Kids After School Lottery Form 2021
If you are interested in attending the Friday, After-School Chess program, please fill out this survey. If you answer No to any of the following questions, it may disqualify you for eligibility in this program.
Student's First Name *
Student's Last Name *
Student's Homeroom *
Parent's Name
If my child is chosen to participate, I give him/her permission to attend via Zoom every Friday starting January 22th- June 15, 2021 from 3:oo -4:00 pm.
Clear selection
In addition, I understand these sessions may be recorded or pictures may be taken for use in our school or on our school website.
Clear selection
Discipline Policy: I understand that if my child does not complete class work assignments, homework assignments or model appropriate behavior, he/she will be removed from the program.
Clear selection
Clear form
Never submit passwords through Google Forms.
This form was created inside of NYC Department of Education.