Cardinal After-School Program (ASP) Enrollment Form 2020-21
We are excited to provide our Cardinal ASP to your student(s)!  Please know that if you have any questions regarding our program you can contact Linda Lowery, Program Coordinator, at 565-2256 ext. 105.
This form is a required component of enrolling student(s) into our Cardinal After-School Program.  Please plan to use this same form for each student who is in 3rd - 12th grade from your household you'd like to enroll into our program.  
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Name of Student *
Grade *
CLUB INTEREST ONLY:   if student is interested in participating in a particular club only please indicate which club.  
If we are to need to run our program virtually or your student chooses to participate in our program through virtual means...will your student have access to a device so that he/she can log into our virtual meetings after school? Your answer will determine next steps in ensuring connectivity for program purposes. *
Expectation: What would you like your student to improve upon while participating in the Cardinal After-School Program? *
Required
What needs might your family have that would assist your student and family in being most successful during this 2020-21 school year?
We have two dismissal times.   5:30   Bus and Parent/Guardian Pick Up   6:00  Parent/Guardian Pick Up only.   Which dismissal option should we plan for your student(s)? *
If you are interested in bus ride option please indicate the address you would like your student ride the bus to.  If no bus ride, please indicate NO BUS *
Parent/Guardian Name:   *
Parent/Guardian Phone Number: *
Parent/Guardian Email Address: *
Emergency Contact information will be required:            Emergency Contact Name: *
Emergency Contact Relationship to Student: *
Emergency Contact Phone Number: *
Cardinal ASP Student Survey:  Student surveys allow for staff to obtain student interest information for planning the enrichment component of our program.  It is important for our students to have a voice in the planning of our program.  Your permission is necessary to allow for our staff to survey your student.                                                                              The Cardinal ASP has my permission to administer enrichment interest surveys to my student(s). *
Academic Practice Time:  Students in grades 6-12 will have time to receive tutoring help within their academic practice time.  It is important that your student, you and our program staff fully understand the expectations and agreements within this component of our program.  1.  Although most students will finish their homework during the Academic Practice component, some may not.  I understand that my student may not finish all of his/her homework during the Cardinal ASP Academic Practice time  2.  Enrichment is a required component of our program.  Students may participate in this component even if they have not completed their homework.  I understand that if my student did not complete his/her homework during ASP Academic practice time he/she will be responsible for completing his/her homework on his/her own time.  3.  I understand that Academic Practice is not meant to be a replacement for parent participation in homework.  4. Communication is vital.  If you have concerns with your students' use and understanding of the academic practice piece please contact Linda Lowery at 608-565-2256 ext. 105   *
Virtual Meeting Agreements: If it is that we are needing to run our program virtually or your student chooses to participate in a virtual setting the following are our agreements.  Students are encouraged to join in on our virtual meetings that we will have scheduled on Tuesdays, Wednesdays and Thursdays!  The following are our virtual meeting agreements for our Cardinal ASP students:  1.  Participate!  We love interaction during this time frame!  We love to see your face whenever possible... so use your video and your voice whenever you can.  2.  Be Present!  Put away anything that is distracting to yourself and others  so that you can be fully Engaged.  3. Be Respectful! Mute yourself when another person is talking.  4.  Use the Chat!   But only use the Chat Box for discussing the topic that we are currently talking about.  The Chat Box is  not for side conversations.  5.  Exiting with Respect.  We get it!  There will be times you need to leave before our time together is done.  You can either let the Teacher know by un-muting yourself when there is a pause in conversation or you can use the Chat Box.  We appreciate you letting us know!   *
Signature line:  By typing your signature signifies you have completed this form *
If you have Questions/Concerns or to expand information regarding the sections above please do so within this section.  Thank you!
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