Preschool Aftercare Interest Form

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If you are interested in aftercare until 6:00pm, please answer the following questions. Completing this survey DOES NOT guarantee your child will be enrolled in aftercare. Your school will receive this information and the aftercare coordinator will follow up with you.

(If you are interested in aftercare for more than 1 child, please submit a separate form for each child.)

Email *

Parent's/Guardian's Full Name *

Parent's/Guardian's Phone Number *

Please provide a valid number that you can be reached at.

Child's First Name *

Child's Last Name
*

What school has your child been placed in for the 2022-2023 school year? *

Are you working? *

Yes

Are you enrolled in school? *

Yes

Do you have access to transportation? *

Yes

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