2021-22 ISS@PS124 Afterschool Program Student Pre-Registration Form
ISS @ PS124 Afterschool Program
PROGRAM DATE (subject to change pending DOE decisions): 9/20/2021 – 6/24/2022: Monday through Friday, 2:30pm-5:45pm (except when school is closed or half day)
GRADES: Pre-K to 5th Graders enrolled at PS 124
FEE SCHEDULE PER STUDENT: $1900/school year, if paid in one installment at the beginning of the school year; $200/month, if paid in ten monthly installments September through June.
SIBLING DISCOUNT: $25 discount for each additional sibling enrolled.
SCHOLARSHIPS: Full and partial scholarships are awarded to eligible families based on household size and household income. We determine scholarships by financial need. More information will be included in the full application form and all families who answer the financial information questions will be considered.

ISS 華僑社會福利社2021-222年在校課後輔導活動
日期 ：2021年9月20日至2022年6月24日
時間： 週一至週五下午2:30至5:45（學校假期日及半日不上課）
學費：學年每人$1900。 如按月付費，每月每人$200 （9月-6月共10 次）
獎學金：我們將根據經濟需要提供全額和部分獎學金。課後輔導活動申請表中將包含財務信息問題，列如家庭規模和家庭收入，所有填寫財務信息的家庭都會被考慮。
同家庭子女折扣：第二個孩子報名減$25。

Scholarship Application Form/獎學金申請表 https://forms.gle/n6BaTvmKSZcpTAUE7

September 13, 2021

Dear PS124 Parents/Guardians:
Please complete this Pre-Registration Form if you are interested in signing your child/children up for ISS@PS124 Afterschool Program for the 2021-22 academic year.

We will notify you as soon as possible if there is a spot for your child to complete the registration process.

Please do not hesitate to contact us at issps124@issnyc.org if you have any questions. We will continue to keep you updated. Thank you!

2021年9月13日

PS124的家長好：
您如果想替您的孩子報名ISS在PS124課後輔導活動，請先填以下的預註冊表格。我們會查詢班級還有沒有位子然後儘快跟您連絡。
有任何疑問，請電郵 issps124@issnyc.org 或打電話/傳短訊到(347)638-3866。謝謝。


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STUDENT INFORMATION 學生個人資料
Please complete one form per student.
Student First Name 學生名字: *
Student Last Name 學生姓: *
學生中文姓名 Student Chinese Name (Optional)
Entering Grade 就讀年級: *
Required
Enrolled School 就讀學校: *
Required
Sex 姓別: *
Date of Birth 出生日期（月/日/年） *
MM
/
DD
/
YYYY
I am interested in registering my child for: 我想替我孩子報名(請勾選適用項): *
Required
I would like to apply for need-based scholarship for my child. 我想為我的孩子申請基於需求的獎學金.
Clear selection
PARENT/PRIMARY GUARDIAN CONTACT INFORMATION 家長/主要監護人資料
(1) Name of Parent/Guardian 家長/主要監護人姓名: *
Relationship to Student 與學生的關係 *
Cell Phone # 電話號碼: *
Email 電郵地址: *
Preferred Communication Channel 最佳聯繫方式: *
Required
Preferred Payment Method 最佳學費付款方式:
Has your child participated in ISS programs before?   你的孩子以前參加過華僑社會福利社輔導班嗎？
Clear selection
If your child is enrolled for the first time, how did you hear about our program? 如果小孩是華僑社會福利社輔導班新生，您是透過那裏得知我們的活動？
Do you know other families who are interested in participating in ISS@PS124 Afterschool Program? If yes, please share with them this form or write their contact information below for us to reach out. 您是否知道其他有兴趣参加ISS@PS124 課後輔導活動的家庭？ 如果有，请与他们分享此表格或在下方填写他们的联系信息，以便我们与其联系:
Do you have any questions or comments to share with us? Please write them here. 如果您有其他问题或建议想与我们分享，请填写在下方:
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