2021-22 SY After-school Student Registration Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

2021-22 SY After-school Student Registration Form

Thank you for your interest in applying for your son's/daughter's enrollment into the Jefferson County School District's We Are Community 21st CCLC After-school Program! This application contains several important sections; please complete the application in its entirety.

PLEASE NOTE: After-school programming will be held Mondays-Wednesdays from 3:30-6:30 beginning August 30, 2021. Transportation and meals will be provided!

More information on the program can be found at https://www.jcpsd.net/wearecommunity

Sign in to Google to save your progress. Learn more

* Indicates required question

Email *

Your email

Next

Clear form

Never submit passwords through Google Forms.

This form was created inside of Jefferson Public School District. Report Abuse