Freedom School Interest Form
Please fill out this form if you are interested in your child attending Freedom School for Summer 2020. Filling out the Interest Form does not guarantee your child a spot in Freedom School! If your child is eligible, you will receive a phone call and information about registration. There is no way of knowing the likelihood of your child receiving a spot in Freedom School once they are placed on the waiting list.
* Required
Email address
*
Your email
Parent Name
*
Your answer
Child(ren)'s Name(s) - Please put your child's name. If you have multiple children, type them in oldest to youngest.
*
Your answer
School(s) - School(s) your child(ren) attend. If multiple, name the school and which child that attends there.
*
Your answer
Grade in school - Your child(ren) grade in school. If multiple name the child and their grade, oldest to youngest.
*
Your answer
Did they attend Freedom School in 2019?
*
Yes
No
If YES, which Freedom School Site did they attend in 2019?
Choose
Alexander Graham
Berewick Elementary
Christ Lutheran (CLC)
CN Jenkins
Highland Renaissance
Martin Luther King, Jr. Middle (MLK)
Marie G. Davis
Montclaire
Mount Carmel
Oakhurst
Pinewood
Providence Day School (PDS)
QC Family Tree
Rama Road
Renaissance West
Shalom Park
The Grove
UNC Charlotte (UNCC)
Home Address
*
Your answer
City, State, Zip Code
*
Your answer
Phone Number
*
Your answer
Alternate Phone Number
Your answer
Which Freedom School location are you interested in attending?
*
Choose
Alexander Graham (1800 Runnymede Lane)
Berewick Elementary School (5910 Dixie River Rd.)
Christ Lutheran Church (4519 Providence Rd.)
CN Jenkins Memorial Presbyterian Church at Druid Hills (2801 Lucena St.)
Highland Renaissance Academy (125 W. Craighead Rd.)
Marie G. Davis (3351 Griffith St.)
Martin Luther King, Jr. Middle School (500 Bilmark Ave.)
Mount Carmel Baptist Church (7237 Tuckaseegee Rd.)
Oakhurst STEAM Academy (4511 Monroe Rd)
Pinewood Elementary (805 Seneca Pl.)
Providence Day School (5800 Sardis Rd.)
QC Family Tree at St. Johns Baptist Church (300 Hawthorne Lane)
Rama Road Elementary ( 1035 Rama Rd.)
Renaissance West STEM Academy (3241 Renaissance Way)
Shalom Park (5007 Providence Rd)
The Grove Presbyterian Church (5735 E. WT Harris Blvd.)
I don't have a preference
Will your child(ren) need transportation to get to Freedom School this summer if they are invited to register?
*
Yes, my child(ren) will need transportation
No, I would be able to provide transportation
Is there any additional information we should know about your child(ren)?
Your answer
Were you referred by another organization
*
Yes
No
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
