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Pine Grove Kids 1st Expanded Learning (Afterschool) Application 2021-2022
Please fill out a SEPARATE FORM for each child enrolling in the Kids 1st Afterschool Program.
You will be notified of participation in the 2021-2022 program by phone and email before June 11th.
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* Indicates required question
Parent/Guardian Name
*
Your answer
Parent/Guardian Phone Number
*
Your answer
Work # for Parent/ Guardian (This will be used ONLY in an emergency or if other contacts can not be reached)
Your answer
Email for Parent/ Guardian (This will be a critical way to receive information.)
Your answer
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Student's ID Number (Lunch Number... If known)
Your answer
Are there any issues we should be aware of? (allergies, shared custody, behaviors, academics...)
*
Your answer
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