SPSB After-School Academic Support Participation Application STUDENT
After-School program will begin this fall (contact school for exact date) and continue until April
After-School hours will be from 3p.m. to 5p.m. Mondays & Wednesdays for current grades 3-8

Priority will be given to students who scored basic and below on either ELA or Math LEAP 2025 assessments.

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LAST NAME of Student *
FIRST NAME of Student *
School Student Currently Attending *
Student's Current Grade Level *
Will your student need a bus to take them home in the afternoons? *
If you answered yes  the bus question above, at what address will the bus need to stop?
PARENT/GUARDIAN LAST NAME *
PARENT/GUARDIAN FIRST NAME *
PARENT/GUARDIAN Contact Phone Number *
PARENT/GUARDIAN Email Address *
Emergency Contact Name *
Emergency Contact Phone Number *
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