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School Age Learning Center Enrollment
In emergencies please contact Dee Liggens at 405.424.5243 Ext 125 or
deejl@urbanleagueok.org
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* Indicates required question
Please SELECT the Program
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Choose
Winter Break 2023
After School Tutoring - Community Hope Center
Millwood Virtual Fridays
Strong Neighborhood Initiative
Spring Break (LIMITED SPACE open March 1st)
Summer Camp (LIMITED SPACE open May 15th)
The Conversation Room - "Let's Talk About It"
Adopt a Family
Today's Date
*
MM
/
DD
/
YYYY
Student Name
*
Your answer
Student School
*
Choose
Thelma Parks
Wilson
MLK
Millwood
Crutcho
John Rex
FD Moon
WK Jackson
SCHOOL BREAK
Date of Birth
*
MM
/
DD
/
YYYY
Grade
*
Choose
Kindergarten
1
2
3
4
5
6
7
8
9
Ethnicity
Choose
Black or African American
White
Hispanic or Latino
Native American or American Indian
Asian / Pacific Islander
Other
Gender
Choose
Male
Female
Prefer not to say
Other
Food Allergies: (Select YES or NO, If YES please list)
*
Yes
No
(If Food Allergies, please list)
Your answer
Special Needs: (Select YES or NO, If YES please list accommodations needed)
*
Yes
No
(If Special Needs, please describe)
Your answer
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