Educational Enrollment Interest Form

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Please fill out our form and we will be in contact with confirmation of enrollment and more details as the start date approaches.

What Program are you interested in? *

Junior Climate Corps (Afterschool Middle School Program)

P.L.A.N.T. Academy (High School Vocational Program)

Student's Name *

Guardian's Name *

Guardian's Phone Number *

Guardian's Email *

Would you like to also be added to our mail list for other CREEC related activities and updates? *

Yes

How to did you hear about the program?

It helps us to know where we need to focus our outreach efforts.

Social media

Website

Flyer shared to schools

Friend

Family

Other:

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