Middle School Youth Applicant Information
Please complete the below information about your student who is applying to be in our Summer Program. There is a $30 fee to apply, which will be accepted the first day of program.
Applicant Youth Name *
Youth Date of Birth *
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DD
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Current Age: *
Grade (Spring 2020): *
School (Fall 2020) *
Grade (Fall 2020): *
Student H.O. # (SFUSD Students Only)
With what gender does the applicant identify? *
Race/Ethnicity: *
Please select your child's t-shirt size *
Please select your child's preferred enrichment *
Please select your child's preferred sport *
Does the applicant have an Individualized Education Plan (IEP) or 504 Plan? *
Has the applicant ever been held back a grade? *
Has the applicant ever been expelled from school? *
Has the applicant ever been suspended from school? *
Is the applicant currently receiving any mental health support or services? *
Has the applicant been diagnosed with a cognitive impairment? *
Allergies (Please Specify): *
Seizures: *
Other medical conditions: *
Required medication(s): *
How would you rate the applicant's reading performance? *
How would you rate the applicant's math performance? *
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