MadisonLEARNs After School Program Application   (Program dates April 13 - June 3, 2021)
$25 non-refundable registration fee due upon acceptance. (Check or money order made payable to PUSD. No cash accepted.) Program is no cost through June 3, 2021.
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Student Information
Student Name (First, Middle Initial, Last) *
Gender *
Date of Birth *
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Race/Ethnicity *
Grade in Fall 2020 *
Student ID#
Does your child's school have cohorts? *
If yes, what cohort is your child in?
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