ConnCAT Safe Space Learning Hub Fall Program-2020-2021  6th-9th grade                    
Welcome to ConnCAT's Safe Space Learning Hub now at TWO LOCATIONS 4 Science Park in New Haven.  Space in this program is limited and selection will be based as evenly as possible by grade and gender.  WE WILL RESUME ACCEPTING APPLICATIONS FOR 6TH AND 7TH GRADE UPON APPROVAL FROM THE CT OFFICE OF EARLY CHILDHOOD. Please fill out the application and note the details below:

DETAILS

-    Program Start Date:  ROLLING ADMISSIONS (follows NHPS calendar)
-    Hours: Mon - Fri 8:00 am-3:30 pm
-    Parents must arrange transportation for drop-off/pick-up

APPLICATION GUIDELINES
-    Parents/Guardians must submit 1 application PER CHILD.

-    Our program heavily relies on text and email to contact parents. Please provide us with ACTIVE phone numbers and/or email addresses that you check regularly.

-    Please click on "SUBMIT" at the very end of the online form to ensure delivery.

*Open enrollment.  Parents will be notified via email of their acceptance status within one week of the application submission.  All other applications will be placed on a Wait-List.  

*Realizing the ever-changing current events regarding the COVID-19 virus, ConnCAT reserves the right to adjust program dates and times accordingly as deemed necessary.  

Questions? Contact Steve Driffin (sdriffin@conncat.org);  Stephanie Mallard (smallard@conncat.org)
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Child Last Name *
Child First Name *
Address *
Street, Unit, City, State, Zip
What location are you applying for your child to attend?
Clear selection
Grade *
GRADE DURING FALL 2020 We will resume processing applications for grades 6 and 7 upon approval from the CT Office of Early Childhood.
Age *
School Name *
Date of Birth (Please manually enter the year) *
MM
/
DD
/
YYYY
Gender *
Does your child have a sibling applying for the ConnCAT Safe Space Learning Hub? *
If your answer is YES, please type their sibling's name(s) in the space provided. A separate application MUST be completed for each child.
Required
Sibling Name(s)
Do you consider your child to be Hispanic or Latino?
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Ethinicity/Race
How did you first hear about the ConnCAT Safe Space Learning Hub? *
Required
Parent 1 Last Name *
Parent 1 First Name *
Parent 1 Street Address *
Street and (Unit #)
City *
Zip Code *
Parent 1 Cell Phone Number (Example: (203) 111-1111) *
Parent 1 Daytime Phone Number (Example: (203) 111-1111) *
Parent 1 Email Address (please ensure email is correct) *
Would you like to receive text notifications for emergencies/occasional updates? *
Remind 101 is a free text message system and is our primary form of mass communication during the summer program. You will NOT be enrolled automatically, but will need to follow a set of instructions on your phone to be enrolled once your child has been admitted to the program. This is MANDATORY for ALL accepted parents.
Parent 2 Last Name
Parent 2 First Name
Parent 2 Cellphone Number (Example: (203) 111-1111)
Parent 2 Daytime Phone Number (Example: (203) 111-1111)
Parent 2 Street Address
Street and (Unit#)
City
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