21st Century Community Learning Centers Electronic Enrollment Form (In-person and Remote)
This form is only to be used for students enrolled into the 21st CCLC program. This form is only valid for 2021-2022 school year.
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This form must be completed in its entirety. This enrollment form is only submitted once the entire form is complete. There are 4 sections: Student/Parent Information, Dismissal and Pick-Up Information, Consent for Photograph/Video Release, and Health Information Your school's Community School Director will contact you to confirm receipt and submission.
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This form was created inside of New York City Department of Education.