Freedom School Scholar Enrollment Form
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Email *
Child's Last Name *
Child's First Name *
Child's Middle Name
Birth Date *
MM
/
DD
/
YYYY
Home Street Address *
City *
State *
Zip Code *
Child's Level *
Grade just completed (2023-24 school year) *
Child's Gender Identity *
Child's Preferred pronoun *
Child's Race/Ethnicity (check all that apply) *
Required
What is your child's reading proficiency level? *
Please list any languages your child speaks at home *
Is your child an English Language Learner? 
(English is not their first language)
 *
Type of School that your child attended for the 2023-2024 school year *
Child's School Name *
School City *
School State *
Does your child receive or qualify free/reduced price lunch at school during the academic year? *
Has your child ever attended a CDF Freedom Schools Summer or After-School program before? *
If yes, how many years has your child participated in the CDF Freedom Schools Program?
Does your child have health insurance? *
If yes, what is your child's health insurance carrier? *
Has your child ever qualified for an Individual Education Plan (IEP) or 504 plan? *
What are some strategies our team can use to best support your child's learning throughout the program? (ex: needs additional reading help, prefers small group)
Does your child have any allergies or health conditions of which we should be made aware of? If yes, what?
Is there anything else you would like to share about your child?
Child T-shirt Size
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