• Summer School Application Form

• 
  
• Date
• Student Name
• Date of Birth
• Student's Current Grade
• Parent/Guardian Name
• Phone

  --
• Email
• Emergency Information

  Contact Name	Relationship	Phone#

• Medical Information

  Physician Name	Phone#	Allergies

• 
  
• Does student have an IEP

  Yes
  No
  
• Type of Summer Study

  Remedial Study
  Art
  Foreign Language
  Music
  Sports
  
• Program Options Select Art Studies Foreign Language - Arabic Foreign Language - Chinese Foreign Language - French Foreign Language - Italian Foreign Language - Japanese Foreign Language - Spanish Music - Classical Music - Jazz Music Popular Music - Opera Sports - Basketball Sports - Tennis Sports - Volleyball Sports - Swimming Remedial - English Remedial - History Remedial - Math Remedial - Science Voice
• Which session are you interested in?

  Session I - June
  Session II - July
  Session III - August
  
• 
  
• Signature