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Application

NOW ACCEPTING AFTERSCHOOL APPLICATIONS!


Program
Select Desired Program
NOTE: GO TO LYRICAL PRE-K PAGE FOR PRE-K APPLICATION
BEFORE/AFTER SCHOOL
Enter Student's Full Name
First Name *
Middle
Last Name *
Gender
Country
Address Line 1 *
Address Line 2
City *
State/Province *
Postal Code *
Ethnic Identity
Racial Identity

Student Has Individualized Education Plan - IEP
If yes, upload copy in pdf or jpeg form.
No file selected
Fine Arts - First Choice
Fine Arts - Second Choice

Prefix
First Name *
Last Name *
Suffix
Country
Address Line 1 *
Address Line 2
City *
State/Province *
Postal Code *
Child Lives With Parent1/Legal Guardian?

Prefix
First Name
Last Name
Country
Address Line 1
Address Line 2
City
State/Province
Postal Code
Child Lives With Parent2/Legal Guardian

First Name
Last Name
Country
Address Line 1
City
State/Province
Postal Code
First Name
Last Name
Country
Address Line 1
City
State/Province
Postal Code
First Name
Last Name
Country
Address Line 1
City
State/Province
Postal Code


Orientation Required
Image Authorization
I give permission for my child's photo or likeness to be used in media related to the program.
Emergency Medical Authorization
I agree that the agency may authorize a medical practitioner of its choice to provide emergency care if a timely response is needed or if I can not be contacted.

Enter Full Name

NOTE: PARENTS OF AFTERSCHOOL STUDENTS MUST CONTACT THE SCHOOL OR CMS TRANSPORTATION TO ARRANGE BUS PICKUP OR DROPOFF

The Family Educational Rights and Privacy Act is a Federal law protecting student education records privacy. Parents have the right to inspect their child's records and request errors be corrected.