ConnCAT Afterschool Program 2019-2020 Application
We are excited to have both new and returning children join us for the school year!
Please note that there will be a $25 required non-refundable registration fee for EACH ADMITTED APPLICANT.

DETAILS
- Program Dates: October 7, 2019-June 12, 2020
- Hours: Mon - Fri :230 pm-6:00 pm
- Snacks will be available
- Parents must arrange transportation for pick-up by 5:45pm.
- Hamden students must be dropped off and picked up. Please check with your child's school if bus transportation is available.

APPLICATION GUIDELINES
- Parents/Guardians must submit 1 application per child.

- Our program heavily relies on text and email to contact parents. Please provide us with ACTIVE phone numbers and/or email addresses that you check regularly.

- Please click on "SUBMIT" at the very end of the online form to ensure delivery.

APPLICATION DEADLINE: September 13, 2019. Parents will be notified via email of their acceptance status by September 20th.

Questions? Contact Stephen Driffin (sdriffin@conncat.org) or Stephanie Mallard (smallard@conncat.org) at 203-823-9823.
HOUSING CODE: This question is only for specific applicants. If you have been provided with a Housing Code from HANH, please enter the code below.
Your answer
Child's Last Name *
Your answer
Child First Name *
Your answer
Address Line 1 *
Street Address
Your answer
Address Line 2
Unit
Your answer
Address Line 3 *
City, State, Zip
Your answer
Neighborhood *
In which Greater New Haven neighborhood do you reside? Please select one.
Grade *
During 2019-2020
Age *
Your answer
School Name *
Your answer
Date of Birth *
Your answer
Gender *
Does your child consider him/herself to be Hispanic or Latino?
Ethinicity/Race
Parent 1 Last Name *
Your answer
Parent 1 First Name *
Your answer
Parent 1 Address *
Street, Unit, City, State, Zip
Parent 1 Daytime Phone Number *
Your answer
Parent 1 Cellphone Number *
Text messages are a primary form of communication for the after school program.
Your answer
Parent 1 Email Address *
**Must provide an active email address that is checked regularly
Your answer
Would you like to receive text notifications for emergencies/occasional updates?
Parent 2 Last Name
Your answer
Parent 2 First Name
Your answer
Parent 2 Daytime Phone Number
Your answer
Parent 2 Cellphone Number
Your answer
Parent 2 Address
Street, Unit, City, State, Zip
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