Spring 2024 -SUNY Orange LPP Program Registration 
Besides fun trips and family activities we are offering academic assistance, a drum program, The Drone Cadets Academy, an Theatre & Arts Program, along with a robust summer program for 5th-7th grade students that is free of cost! If you would like further details please complete this attached form and feel free to give us a call to discuss the program further, we can be reached at 845-341-4265. Must complete the Alternative bus transportation form for afterschool busing from school. 
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Email *
Student's Full Name *
Student's Date of Birth *
Student's School ID # *
Current School  *
Current Grade *
Program Eligibility: Reasons for Referral (Check all that apply): *
Required
Primary Eligibility:
Of the Factors checked above, please indicate which is the primary factor for registering the student?  
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School Guidance Counselor (if applicable) *
Student Email Address *
Parent/Guardian Name *
Current Address *
Parent/Guardian Cell/Home Phone Number *
Alternative Phone Number *
Parent/Guardian Email Address (Please check your spam box for LPP Emails) *
Emergency Contact Name *
Emergency Contact Phone Number *
Does your child receive Free or Reduced Lunch? *
(Student) SUNY Orange LPP is a year around program, during the school year we meet 4 days a week. Participation is absolutely non-negotiable. Students should come with an open mind and willingness to participate in the activities. Are you able to commit to at least two days of attendance and participation? Please make the Director and/or Office manager aware of a students other commitments during registration for program activities.  *
(Student): The SUNY Orange LPP After-School program is committed to advancing your educational goals while meeting your educational needs by offering academic assistance, It is imperative that you come ready, willing, and able to participate during the academic assistance hour each day.  We take academics very seriously in this program and expect students to come prepared  for what we have to offer academically. Can you commit to taking an active role by bringing homework, classwork, and/or school projects to work on during this time? *
SUNY Orange LPP plans to actively take trips, attend seminars, workshops, and participate in activities outside of normal after-school program hours and days. These events are open to all of our LPP Scholars, however, attendance, participation, program behavior, along with other determining factors such as grade levels & age requirements will decide who we extend invitations too. Please acknowledge you understand the selection process by checking the "confirmed" button.  *
Required
(Parent): SUNY Orange LPP plans to make every effort to engage our parents and have them as active partners in the program. Would you be interested in either of the following: *
Required
SUNY Orange LPP & the NECSD provide busing to our program via the transportation departments after school services. You must complete this alternative stop form in order for your child to be bused from school to our program. Please complete the attached goggle document, which assist NECSD transportation department in assigning your child to the correct bus. We are listed under Special Transportation, then choose Afterschool Program and input Liberty Partnerships Program. The address is 1 Washington Center, Newburgh, NY 12550. The contact number is 845-341-4265. If you have any issues please call for assistance. 

Complete this form: 

https://docs.google.com/forms/d/e/1FAIpQLScmR9Clm7OAMZKJp4lpXX0Bn4lpfWJ7iijPAnJcJi-60DlT7A/viewform


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(Parents): The program begins upon the students arrival after school and will end at 5:00 pm, and will be dismissed. Please pick your child up no later than 5:15 pm. If you plan to be late, please call the office ahead of time to give the staff appropriate notice. Please indicate the level of consent on this form.  *
Required
(Parents): Does your child have any food allergies or dietary restrictions?
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Does your child have any medical conditions that we should be aware of?  ie, allergies, seizures, etc? *
Does your child take any medications that we should be aware of? *
Does your child receive any special education services?  If so, what services?  Does your child have an IEP, 504, or a Behavior Plan? *
COVID-19 has had a significant impact on our students'mental and emotional health. SUNY Orange LPP was glad that we could continue the program throughout that difficult time. We would like to continue being that support system for our students and families. Please note that SUNY Orange LPP is available to provide support, connect you to resources, and be there to advocate when necessary. If you feel there is some concern in these areas, feel free to reach out to the Program Coordinator or Director for assistance.  *
Required
SUNY Orange Liberty Partnerships Program has a zero tolerance policy for verbal abuse, bullying and/or physical assaulting of students and/or staff. In the event of one of these incidents, SUNY Orange LPP & SUNY Orange Community College shall handle them on a case by case basis. *
Required
Its a privilege to provide our programming on the SUNY Orange Newburgh campus. We expect our students to respect the property, which includes the classrooms, bathrooms, hallways, and any equipment we are using. SUNY Orange Community College has a strict policy against vandalization and destruction of school property, any violation of this policy could result in the student being asked to leave the program & campus. Please discuss this with you child and acknowledge receipt.  *
Providing our students with the right academic and socio-emotional supports is important to the SUNY Orange Liberty Partnerships Program. We base a lot of our programming on the needs of our students, we find out about these needs based on discussions with our students and parents. However, we also utilize self assessments, such as the Indigo Pathways assessment.  Please have your child complete this assessment as part of our registration packet. They can use their school email address for login. Please have them write down their login/password information as we will be utilizing these results during the year.

Assessment Link: https://www.indigopathway.com/survey?org=kddo6bzv4if&link_login=2c4f2865-a8eb-41b0-bb64-c8b39ae8e237
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On the first day that your child attends, they will be sent home with a copy of this registration, please review, sign, and return it to the program within 3 business days to complete your child's registration in the program. *
Required
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