Middle School Interest Survey

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If you are interested in your child attending extended day, please complete this survey. Please submit one survey per child. Your child can start attending once your form is submitted. The deadline for form submissions is Thursday, August 26.

For program details, location, and pick-up protocols, please visit www.esdallas.org/esdplus.

If you have questions, please contact Sandy Hernandez, Director of After School Programs at hernandezs@esdallas.org.

Email *

Student First and Last Name *

Emergency Contact First and Last Name *

Emergency Contact Phone Number *

My Student Will Likely Attend *

Full Time, Monday - Friday

Part Time, Various Days Each Week

Send me a copy of my responses.

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