Irvington PTA After School Activities Scholarship Application 

The Irvington PTA provides scholarships for Irvington-based extracurricular activities that require a fee. Students qualifying for free or reduced price lunch qualify for scholarships. Each qualified student is eligible for a scholarship for ONE after school activity per term that scholarships are available. The PTA board will update the community before each term on the availability of scholarships for that term, based on the approved budget. The PTA will pay the enrollment fee directly to the activity provider. 

Note:

2022-23 Irvington PTA Scholarships will not be provided for Northwest Children’s Theatre drama or for Girls on the Run clubs. NWCT provides their own need-based scholarships which you can apply for through their registration site nwcst.com/drama-club. Girls on the Run (late winter/spring) has a sliding scale that starts at just $20. Contact Carolyn Sykes at csykes@pps.net to enroll in Girls on the Run.

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Please Initial:

I give permission to Irvington PTA Scholarship coordinator to register my child(ren) for after-school activities. This includes sharing their information with providers and paying registration fees. I agree to help ensure that my child attends their registered after school activities. I understand that the Scholarship coordinator will do their best to register my child for their first choice after school activity but that, as classes fill, a second choice may be registered for. After activity registrations & payments are complete, I agree to be solely responsible for all other communications with the activity providers.
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Parent/Guardian Name *
Parent/Guardian Email *
Parent/Guardian Phone Number *
Student Name *
Student Age *
Student Birthdate *
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Student Preferred Pronouns
Teacher Name *
Pick Up Person(s) Authorized:
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Will your child go to IED after?
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Does your child have permission to walk home?

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After-School Activity (First Choice):
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After-School Activity (Second Choice):
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Is your child a returning student to either of these activities

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If yes, which one?

Emergency Contact Name (Different than parent previously listed):

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Emergency Contact Phone Number:
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Emergency Contact Email:

Student T-Shirt Size:

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The next section are questions related to specific activities.  Please answer what feels relevant, and skip others that you feel do not apply.

Are there any behaviors that might affect your child's participation in a group setting?

Dietary Needs:

Allergies & Medications:

Does your child have learning difficulties?


Does your child have experience in French or Spanish language?
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Has your child taken music lessons before?

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