WLPCS Summer School Course Request Form Summer 2019
To enroll in Summer School, please complete this form in its entirety. Please note that completing a form does not guarantee you a spot in Summer School; Ms. Foley will confirm your registration at a later date.
Email address *
Student First Name *
Your answer
Student Last Name *
Your answer
2018-2019 Grade Level (This Year) *
Student E-mail *
Your answer
Parent/Guardian #1 First Name *
Your answer
Parent/Guardian #1 Last Name *
Your answer
Parent/Guardian #1 Relationship to child *
Your answer
Parent/Guardian #1 Phone Number *
Ex. 202-223-1111
Your answer
Parent/Guardian #1 E-mail *
Your answer
Parent/Guardian #2 First Name
Your answer
Parent/Guardian #2 Last Name
Your answer
Parent/Guardian #2 Relationship to child
Your answer
Parent/Guardian #2 Phone Number
Ex. 202-223-1111
Your answer
Parent/Guardian #2 E-mail
Your answer
Emergency Contact First Name *
Your answer
Emergency Contact Last Name *
Your answer
Emergency Contact Relationship to child *
Your answer
Emergency Contact Phone Number *
Ex. 202-223-1111
Your answer
Emergency Contact E-mail *
Your answer
Please select which session(s) you are available. *
Are you registering for Middle School or Upper School?
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