Social Group Interest Form
Please take the time to fill out this form. Upon receipt, those new to the center will be contacted to set up a "Meet and Greet" appointment. This will allow us to learn about your child and determine which group is most appropriate.
* Required
Email address
*
Your email
Child's Name
*
Your answer
Grade (2017-2018)
*
Choose
Preschool
Transition K
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Other
Child's Date of Birth
*
MM
/
DD
/
YYYY
Parents Names
*
Your answer
Phone Number
*
Your answer
Address
*
Your answer
My Child IS available for on the following days/times. (Check all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
1pm
2pm
3pm
3:15pm
3:30pm
3:45pm
4pm
4:15pm
4:30pm
4:45pm
5pm
5:15pm
5:30pm
5:45pm
6pm
Monday
Tuesday
Wednesday
Thursday
Friday
1pm
2pm
3pm
3:15pm
3:30pm
3:45pm
4pm
4:15pm
4:30pm
4:45pm
5pm
5:15pm
5:30pm
5:45pm
6pm
I am interested in the following group:
*
Social Adventurers ( Preschool-K)
Mad Scientists (Pre-K -Grade 1)
Storytime (Preschool-K)
Think It, Move It (Preschool-K)
Take 1, Take 2 (Elementary)
Around the World (Elementary)
Social Smarts (Elementary K/1)
The Detective Agency (Elementary Grades 2-3)
Superhero Training Academy (Elementary Grades 3-6 )
In the Moment ( Elementary )
YouTube Decoders (Elementary)
Teen Hangout (Middle/High School)
PEERS (Middle/high School)
Parent Coaching
Required
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This form was created inside of CCL.
Report Abuse
-
Terms of Service
-
Additional Terms
Forms
