REACH Registration Form 2023-2024

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START DATE (Tentative): September 18, 2023
DAYS & TIME: Monday - Friday for 3 hours after school (every day there's a full day of school)

ATTENDANCE: Regular attendance is required (please read attendance policy at the bottom of form)

REACH is an afterschool program for students in 6th, 7th, & 8th grade at the PMS. Space is limited, so if your child is accepted, attendance on a regular basis is mandatory. Once the program fills up, your child's registration form will be on the REACH waiting list.

Student Name *

Address *

Grade (as of 2023-2024 school year) *

6th

7th

8th

Is your child new to the Phillipsburg School District this year? *

Yes

What is the primary language that is spoken at home? *

English

Spanish

Parent or Guardian *

Home Phone

Cell Phone

Work Phone

Emergency Contact #1 (Name & Phone Number) *

Emergency Contact #2 (Name & Phone Number) *

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