ConnCAT Afterschool Program 2021-2022 Application

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We are excited to have both new and returning children join us for the school year!
Please note that there will be a $50 required non-refundable registration fee for EACH ADMITTED APPLICANT. ONLY 30-40 APPLICANTS WILL BE ACCEPTED THIS YEAR.
If you cannot meet the registration requirements due to hardship, please respond via email and in the subject line type: "Hardship" followed with an explanation in the body. It will be determined if you qualify for the limited scholarships or sliding scale.

DETAILS
- Program Dates: October 4, 2021-June 10, 2022
- Hours: Mon - Fri 2:30 pm-6:00 pm
- Light snacks will be available. Students may bring personal snacks. No microwaved foods allowed.
- Parents must arrange transportation for pick-up by 5:45pm.
- Non-New Haven students must be dropped off and picked up. Please check with your child's school if bus transportation is available.

APPLICATION GUIDELINES
- Parents/Guardians must submit 1 application per child.

- Our program heavily relies on text and email to contact parents. Please provide us with ACTIVE phone numbers and/or email addresses that you check regularly.

- Please click on "SUBMIT" at the very end of the online form to ensure delivery.

APPLICATIONS accepted until SEPTEMBER 30TH.
Early Bird application MUST BE submitted by : SEPTEMBER 10, 2021. Parents will be notified via email of their acceptance status by SEPTEMBER 15th. ONLY 30-40 APPLICANTS WILL BE ACCEPTED THIS YEAR.

Questions? Contact Stephen Driffin (sdriffin@conncat.org) or Briana McLean (bmclean@conncat.org) at 203-823-9823 ext 113

Did your child attend the ConnCAT Summer Arts Program 2021 ? *

Yes

Child's Last Name *

Child's First Name *

Age *

Date of Birth *

YYYY

Gender *

Female

Male

Other:

Grade (2021/2022 school year) *

Address-Street, City, State, Zip Code *

Neighborhood *

Dixwell

Dwight

Hill

Fair Haven

Newhallville

Westville

Hamden

East Shore

School Name *

Is your child Hispanic or Latino? *

Yes

Ethinicity/Race *

Black or African American

White/Caucasian

American Indian/ Alaskan Native

Multi Racial

Asian/Pacific Islander

Parent 1 Last Name * *

Parent 1 First Name *

Parent 1 Address *

Street, Unit, City, State, Zip

Same as child

Other:

Parent 1 Daytime Phone Number *

Parent 1 Cellphone Number *

Text messages are a primary form of communication for the after school program.

Parent 1 Email Address *

MUST provide an active email that is checked regularly

Would you like to receive text notifications for emergencies/occasional updates? *

Yes

Parent 2 Last Name

Parent 2 First Name

Parent 2 Daytime Phone Number

Parent 2 Cellphone Number

Parent 2 Address

Street, Unit, City, State, Zip

Same as child

Other:

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