• Targeted Grades: 5 – 8
• Class Size: Maximum of 15 students
• Time Commitment: 5 days per week, 2:30pm-5:30pm (extended day available)
• Program Dates: September 13, 2010-June 18, 2011

The After-school Support program offers academic support to students in grades 4-8. We offer homework assistance in math, English Language Arts, history, social studies and science. Students are not given the answer but are taught how to discover the answers. This program is available Monday to Thursday from 2:30pm – 5:30pm.

Registration – Please be sure to complete all pages of the registration form before proceeding to the payment page.

Section 1 - Parent Information

1. Parent's First Name(required)
2. Parent's Last Name(required)
3. Street Address(required)
4. Street Address 2
5. City(required)
6. State(required)
7. Zip Code(required)
8. Home Telephone(required)
9. Cellular Phone(required)
10. Work Phone
11. Fax
12. Email Address(valid email required)

Section 2 - Student Information

1. Student's First Name(required)
2. Student's Last Name(required)
3. Age 4 5 6 7 8 9 10 11 12 13 14 15 16 (required)
4. Date of Birth(required)
5. Name of School this Year(required)
6. Grade this Year K 1 1 3 4 5 6 7 8 (required)
7. Grade in Sepetember K 1 1 3 4 5 6 7 8 (required)
8. What were the results of your child's last examination in Mathematics?(required)
9. What were the results of your child's last examination in English Language Arts?(required)
10. Is your child on an IEP No (required)
11. Does your child habe any learning disabilities No
12. Is so, please explain
13. What would you like your child to be able to do at the end of the program(required)
14. Is there any other pertienent information that we should know (i.e. allergies)(required)
15. Student's Special Talents(required)
16. Student's Favorite Pastimes(required)
17. Spoken Languages(required)
18. How did you hear about our program(required)

Part 3 - Authorized Pick-Up

1. Person 1 Authorized for Pick-Up(required)
2. Name(required)
3. Relation to Student(required)
4. Telephone(required)

Person 2 Authorized for Pick-Up

1. Name(required)
2. Relation to Student(required)
3. Telephone(required)

Person 3 Authorized for Pick-Up

1. Name
2. Relation to Student
3. Telephone

 

cforms contact form by delicious:days