2021 ConnCAT Summer Youth Program Application
We all can agree that 2020 did a job on us, but we are here and we are excited to have both new and returning youth join us for another series of special arts workshops and fun! Please fill out the application carefully.

DETAILS
- DUE TO COVID-19, ONLY 40 YOUTH WILL BE SELECTED into the program
- Sibling preference will not be implemented this year.
- Program Dates: July 6 - August 13, 2021
- Hours: Mon - Fri 10:00 am- 4:00 pm
- Lunch will be provided by the New Haven Food Service Department; however, youth may bring their own lunch.
- ALL STUDENTS MUST BRING WATER BOTTLES
- Parents must arrange transportation for drop-off/pick-up
- All registration fees will be waived for 2021

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 accurate email addresses that you check regularly.

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


APPLICATION DEADLINE: JUNE 11, 2021. Parents will be notified via email of their acceptance status by June 18th.


Questions? Contact Steve Driffin (sdriffin@conncat.org) or Stephanie Mallard (smallard@conncat.org) at 203-823-9823
Email *
Did your child actively attend one of the Learning Hubs this year? *
Required
If "Yes", which Learning Hub did they attend? *
Child Last Name *
Child First Name *
Address *
Street, Unit, City, State, Zip
Grade *
NOT CURRENT GRADE, BUT GRADE YOUTH WILL BE DURING 2021-2022 SCHOOL YEAR
Untitled Title
Age *
School Name *
Date of Birth (Please manually enter the year) *
MM
/
DD
/
YYYY
Gender *
T-Shirt Size *
Does your child have a sibling applying for the Summer 2021 Program? *
If your answer is YES, please type their sibling's name(s) in the space provided. A separate application MUST be completed for each child.
Required
Sibling Name(s)
Do you consider your child to be Hispanic or Latino?
Clear selection
Ethinicity/Race
How did you hear about ConnCAT Youth Programs? *
Required
Parent 1 Last Name *
Parent 1 First Name *
Parent 1 Street Address *
Street and (Unit #)
City *
Zip Code *
Parent 1 Cell Phone Number (Example: (203) 111-1111) *
Parent 1 Daytime Phone Number (Example: (203) 111-1111) *
Parent 1 Email Address *
Would you like to receive text notifications for emergencies/occasional updates? *
Remind 101 is a free text message system and is our primary form of mass communication during the summer program. You will NOT be enrolled automatically, but will need to follow a set of instructions on your phone to be enrolled once your child has been admitted to the program.
Parent 2 Last Name
Parent 2 First Name
Parent 2 Cellphone Number (Example: (203) 111-1111)
Parent 2 Daytime Phone Number (Example: (203) 111-1111)
Parent 2 Street Address
Street and (Unit#)
Clear selection
City
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