Workshop Registration: Student Information

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This fall we are offering two weekly workshops:

Adventurous Authors (grades 4-6), Wednesdays, 4:30-5:45 p.m., six weeks beginning September 16.
*NOTE - THE FIRST SESSION HAS BEEN POSTPONED TO SEPTEMBER 30 TO ALLOW MORE TIME FOR ENROLLMENT. THE LAST SESSION WILL BE NOVEMBER 4.

Writing & Publishing Apprentices (grades 8-12), Mondays, 4:30-6:00 p.m., 10 weeks beginning September 21.

These workshops will take place virtually over Zoom.

Please take note of age restrictions before signing students up for workshops!

Workshop Choice *

Student's First Name *

Student's Last Name *

Grade *

Date of Birth (please make sure to select the correct year!) *

YYYY

Gender *

Female

Male

Prefer not to say

Non-Binary

Other:

School *

Type of School *

Does your student qualify for Free or Reduced Price Lunch? *

Yes

Don't Know

Does your student have permission to walk home by themself? *

Yes

The following people are authorized to pick up this student:

Student's Email (Optional)

Student's Cell Phone Number (Optional)

Is your student enrolled in an English Language Learner program (ELL/ESL)? *

Yes

If yes, what level has your student been assigned? (Please refer to your latest report card)

Does your student have any special needs (e.g. learning, physical or mental health)? *

Yes

If yes, please explain:

Does your student have an Individualized Learning Plan (IEP)? *

Yes

If yes, please explain:

I give 826 Valencia permission to communicate these needs to volunteers in order to support their work with my student.

Yes

Clear selection

Student's First Language(s) *

Language(s) Spoken at Home *

Race/Ethnicity *

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