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Program Preregistration & Information
Please complete the form below to tell us about your interest in ROC ED's programs.
You can also visit
www.roced.org/programs
or call (312) 719-0178 to learn more about our programs and fess. Thank you.
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Today's Date
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Parent's First and Last Name
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Your answer
Parent's Email Address
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Parent's Phone Number
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Child's First and Last Name
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Your answer
School Name, City and District Number
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Your answer
Desired enrollment start date
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Child's Grade in FALL 2023
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Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Required
I would like
more information
about:
Before School Enrichment Program - grades K-8
After School Enrichment Program - grades K-8
I would like
to register
my child for:
Before School Enrichment Program - grades K-8
After School Enrichment Program - grades K-8
Youth Peacemaker Pods (YPP) - grades 9-12
I would like to volunteer at ROC ED:
Yes
No
Maybe
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