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21st CCLC 20/21 Parent Interest Form
Please complete this interest form for the 21st CCLC after school program. If you have more than one child attending CLMS, please complete this form individually for each child.
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* Indicates required question
Student Name
*
Your answer
Parent Name
*
Your answer
Grade Level
*
6th
7th
8th
Parent Phone Number
*
Your answer
Parent Email Address
*
Your answer
Parent involvement in the program is required once per month. Are you available and commit to this requirement?
*
Yes
No
Maybe
Parents are required to attend an orientation before your child may begin the program. Will you attend a virtual orientation?
*
Yes
No
Maybe
Student attendance is required daily. The program is not a drop off and pick up program. Will you be able to commit to your child attendance daily?
*
Yes
No
Virtual Student (Does not apply)
All students are required to attend daily from 4:30 to 6:45. Will you be committed to your child's attendance during digitally ASP?
*
Yes
No
My child will be rejoining the school building for the last 9 weeks and will be in-person for ASP the last 9 weeks.
*
Option 1
Once students rejoin the school building, will your child be a car rider or bus rider for the ASP program?
*
Car rider
Bus Rider
Both
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