Jan 2021 Virtual Learning Interest Form

Jan 2021 Virtual Learning Interest Form
Memphis Athletic Ministries (MAM) is opening January registration for Virtual Learning support to students and families across the city of Memphis. If interested, please complete the form below.

(COMPLETION OF THIS INTEREST FORM DOES NOT GUARANTEE PLACEMENT)

Locations Map

DATES: Begins on or before Monday, January 11, 2021
HOURS*: 7:30 AM - 5:00 PM (*Hours may vary)
GRADES: 3rd - 8th

MAM Provides:
- A supervised, safe, and supportive environment
- Strong and reliable internet connection
- Breakfast, lunch, and snack provided by SCS & YMCA
- Brain breaks and socially distant physical activities
- Schedules aligned to your child’s school schedule
Student Expectations:
- All students will be expected to wear a mask except when eating.
- All students must bring their virtual learning devices each day.
- All students must follow all the site behavior rules.
Parent/Guardian Name *

First Name Last Name
Parent/Guardian Email *
example@example.com
Parent/Guardian Phone *
Please enter a valid phone number.
Preferred Site *
Alternate Site
How many children in 3rd - 8th grade do you want to register ? *
Check if each statement if you understand and agree: *

Completion of this interest form does NOT guarantee placement for my children. I will be contacted by a MAM representative by email or phone by Fri, Jan 8th. If my children are placed, I will have to complete a student waiver on each of them.
Should be Empty: