Afterschool Credit Recovery Sign-Up Form
Afterschool Credit Recovery Registration Form

Monday - Thursday (February 3, 2020 - May 22, 2020)

Priority will be given to seniors, as space is limited.

*Transportation is available to those who register by 1/15/20.
Parents must provide transportation for those who do not register in advance.

Facilitator will provide confirmation prior to the start of credit recovery sessions.
Student first name *
Your answer
Student Last Name *
Your answer
Student ID# *
Your answer
Current Grade (2017-2018 School Year) *
Do you have an active Connexus Course? *
Will you need bus transportation to get home at 5:45pm? If yes, please provide address below. *
Student Home Address
Your answer
Select all days you would be likely to attend credit recovery afterschool? *
Parent/Guardian Name *
Your answer
Parent/Guardian Primary Contact Number *
Your answer
Parent/Guardian Email Address
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Any Allergies/Medical Concerns *
Your answer
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