Astoria Values Summer Camp 2019
Here is the Summer Camp 2019 application form. At the bottom of the form, please explain what days and times you would like to schedule your child to attend.
First Name *
Your answer
Last Name *
Your answer
Gender *
Email Address *
Your answer
Home Address *
Your answer
Birthday *
MM
/
DD
/
YYYY
Nationality/Language Spoken
Your answer
Phone Number *
Your answer
How well do you speak English?
Place of Birth
Your answer
Grade *
Your answer
School Your Child Attends *
Your answer
School Address
Your answer
School Phone Number
Your answer
Subjects You Need Help in (1 is the MOST and 5 is the LEAST)
1
2
3
4
5
Math
Science
Social Studies
English
Other Languages
Do you have any allergies? *
If yes, please explain.
Your answer
Please list the day(s) and time(s) you would like your child to attend the Summer Camp. *
Your answer
Does your child need help with reading comprehension or writing skills? Please explain.
Your answer
Does your child need help with math or other subjects? Please explain.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service