2022-23 Tribe Time Application -MS/HS
Chickasaw Middle and High -  21st Century CCLC Program

Tribe Time operates Monday - Thursday from 3:00-5:30 pm.

For students in 6th grade through 11th grade.  

There will be a MANDATORY parent meeting that MUST be attended in order for your child to join.  Dates will be announced in your acceptance email.  

If you have questions, please email klancaster@chickasawschools.com or kgraham@chickasawschools.com
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Email *
Parent Name *
Parent Email Address *
Student Last Name *
Student First Name *
Student Birthdate *
MM
/
DD
/
YYYY
Student Gender *
Phone Number *
Grade (The grade level for the 2021-22 school year) *
Race *
Does your child receive Special Education Services *
List any special medical condition that may need care during the course of after school activities(Include Allergies) if none type n/a *
Emergency Contact Name *
Emergency Contact Phone Number *
A copy of your responses will be emailed to the address you provided.
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