Cypress Hills LDC Afterschool Enrollment Form
Thank You for your interest in enrolling your child in the Cypress Hills Local Development Corporation's After School Programs, funded by the Department of Youth and Community Development (DYCD), 21st Century Community Learning Centers and/or Advantage Afterschool Programs. Your completion of this form does not guarantee a space in our program. A Director will be in contact with you to verify the information you have provided and to facilitate a Parent Orientation to guide you through the agency's Policies and Procedures. We look forward to working with you to provide high quality and engaging program activities to your child.
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Program Type *
For in-person/hybrid programming, what School Cohort is your child a part of? Select 1 *
Required
Child's First Name
Child's Last Name *
Child's Date of Birth *
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/
DD
/
YYYY
Home Address (Number, Street, City, Zip Code) *
Child's Primary Language *
How well does the child speak English? *
School *
Current Grade (September 2020) *
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