SRTM After School Program 2026-2027

Please fill out this form to let SRTM (After School Provider) and your child's school know that you're interested in the after school program.

Please note: This application does not guarantee your child a spot in the program. Additional steps will be required to complete enrollment.

SRTM is an outside contractor that provides afterschool programs at the schools. We do not have access to school records, so parents/guardians are responsible for providing all documents necessary for enrollment. Students are not fully enrolled until all required documentation has been submitted and families have attended orientation.

Vouchers are required for eligible families. You can apply for the NJ Child Care Assistance Program (CCAP) at www.ChildCareNJ.gov. Families who are not voucher-eligible will be screened to determine scholarship eligibility. Application support is available if you need assistance completing this form.

If you submit this application and haven't heard back within 7 days, please contact us at luz@srtme.org or call 856-524-5132.

Please ensure your contact information is accurate and up to date. If we are unable to reach you by phone or email, your application will be disregarded and your child will be placed on the waitlist.

Thank you for your interest in our program! Visit our website at www.srtme.org to learn more.


Email *
How many children are you registering for the afterschool program?  *
Child 1 First name and last name?  *
Child 2 First name and last name? 
Child 3 first name and last name?
Date of Birth child 1  *
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Date of birth child 2
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Date of birth child 3
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Grade Child 1 *
Grade Child 2
Clear selection
Grade Child 3
Clear selection
Current school  *
Parent First Name *
Parent Last Name
Cell Phone  *
Address *
City 
Zip Code 
Does your child have any allergies? If yes, please list allergies. If enrolling multiple children, please specify the child.  *
Does your child have any health issues/concerns that we should be aware of?  If enrolling multiple children, please specify the child.  *
Does your child have an IEP or 504 plan. If yes, please provide a copy.  *
Students language  *
Student ethnicity  *
Emergency Contact 1 name, relationship and phone number.  *
Emergency Contact 2 name, relationship and phone number.  *
Are there any people who Cannot pick up your child because of a court order? If yes, Provide a copy of the court order.  *
In order for child(ren) to attend the SRTM After School Program we need to know the parent/guardian's status. Please check below for all that apply to you. Families that qualify are required to apply for a voucher  *
Required
Do you currently have a child care subsidy through a voucher?
Clear selection
Do you need financial assistance/scholarship to afford childcare?  *
The following is required for the afterschool program 2025-2026. All parent/guardians who enroll students must leave students in the program until 5pm daily. Students who are picked up early more than (5) days per school year will be recommended for program dismissal unless the parent can provide justification of early pick up. Ex: doctor, other extra curricular activities non affiliated with the school. Additionally any student who is absent from after school more than 5 days will be considered for program dismissal and any student who misses more than 10 days will automatically dismissed unless they have been excused by the program staff or school staff with a valid reason such as sickness or hospitalization, and other impending circumstances. Parents are expected to disclose any life altering issues to help SRTM support their children during the transition.  *
Required
Parents/Guardians who complete this SRTM After School Application are not accepted into the program until you have also completed the Camden County Child Care Voucher, or your child has a WFNJ voucher, or DYFUS voucher. The School that your child attends has a limited amount of funding to utilize towards the cost of after school. If you delay or do not complete the child care voucher your child will automatically be waitlisted after 5 days of receipt of this application. All child care applications need to be turned into Camden County Office in blackwood or emailed to their office. Please DO NOT drop off any at your child's school they will not be processed and this will also cause your child to be automatically waitlisted. All families receiving public assistance( TANF, food stamps, DYFUS) will need to contact your case worker for the child care subsidy and WILL NOT need to fill out the child care voucher application from Camden County. SRTM staff is available to assist you with your child care application daily from 2pm-5:30 pm. If you are in need of a special appointment please contact us at 856-524-5132 or luz@srtme.org, FAILURE to COMPLETE this process timely will delay your child(ren)'s ability to attend the program. Additionally, all parents are REQUIRED to attend the SRTM Parent Orientation prior to their child attending the program.  *
Required
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