Extra Mile Interest Form
The Extra Mile after school program at Circleville Middle School and Circleville High School is set to launch on September 17th and run through the end of April. The program will run daily from 2:30-5:30 p.m. Busing provided for students who live within district boundaries.

Fill out the interest form below and the you will be contacted with details about the enrollment process.
Student Name(s) *
Your answer
Guardian's Name
Your answer
2019-2020 Grade: (6th-8) *
Your answer
2019-2020 Student Grade: *
Your answer
Address *
Your answer
Guardian Daytime Telephone Number *
Your answer
Guardian Evening Telephone Number *
Your answer
Homeroom Teacher's Name *
Your answer
What days will your child be attending?
Notes: *
Your answer
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