Please complete this form by the deadline for your child to be registered for Extended School Year programs. If you have questions, please  contact your child's case manager or call 510.644.6210 to leave a message and a member of the Special Education Team will return your call as soon as possible.

If you have more than one child eligible for ESY services, please complete a separate form for each child.

GENERAL INFORMATION – Preschool - Elementary-Middle School - High School

• Location and Times: Preschools: Hopkins and Franklin (9:15 am to 12:45 pm), Monday - Friday
                                            Elementary: BAM, Rosa Parks, Washington (8:45am to 12:15 pm), Monday - Friday
                                            Middle School: BHS (9:00 am to 12:30 pm), Monday - Friday
                                            High School: BHS (9:00 am to 12:30 pm), Monday - Friday

• Dates:                         Preschools: June 16, 2022 to July 15, 2022 (no school June 20th and July 4th)
                                            Elementary: June 16, 2022 to July 15, 2022 (no school June 20th and July 4th)
                                            Middle School: June 16, 2022 to July 15, 2022 (no school June 20th and July 4th)
                                            High School: June 13, 2022 to July 22, 2022 (no school June 20th and July 4th)

PLEASE KEEP THE ABOVE FORM FOR YOUR INFORMATION AND RETURN THE BELOW PART TO YOUR CHILD'S TEACHER.

You Must Complete This Form by May 6, 2022 to be Registered