Information about your child
  Child’s name: *
  Child’s grade: *
  Child’s attending school *
  Child’s classroom teacher *
  Contact information
  Parent/Guardian’s Name *
  Name of person to pick up *
  Address *
  City *
  State *
  Zip code *
  Home Phone *
  Work Phone *
  Cell Phone *
  E-mail Address *
  Emergency Contact Name *
  Program selection
  - After-school Academy  
 

5 days  4 days 3 days 2 days
  -Enrichment Program  
  English         Math           Writing        Reader's Theater        Test Preps        Chinese
  -Individual tutoring  
  English             Math                 Writing              Test Preps     Chinese