H.A.A.H. Community Learning Center After School Program

H.A.A.H. Community Learning Center After School Program

Students who attend will receive afterschool educational intervention, enrichment, and tutoring services with our licensed professionals. We will offer homework help, as well as reading and math intervention and enrichment activities. Snacks will be provided daily as well. Our program will run Monday-Friday, 2:30-6:30pm. This educational program is designed for K-8th graders. All applicants are responsible for a $25 enrollment fee plus first week with application. Tuition is a flat rate of $125 a week and all fees are due every Monday for each High Achiever. All fees are non-refundable.
Child Name 1
Gender
Age and D.O.B
Grade
School
Child Name 2
Gender
Age and D.O.B
Grade
School
Child Name 3
Gender
Age and D.O.B
Grade
School
Child Name 4
Gender
Age and D.O.B
Grade
School
Parent Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Is it ok to text?
Emergency Contact

First NameLast Name
Emergency Contact Number

Area CodePhone Number
Relationship to High Achiever(s)
Others living in residence with High Achiever(s) and Relationships
Please list other adults authorized to pick up your child(ren): Name, Relationship and Phone Number
Will the Child(ren) need to take any medications during program (if so, please list, if more than one child, list by name)
Does your child have any specific needs?
Health Insurance Carrier, Name of policy holder, Identification Number and Group Number
How did you hear about High Achievers Aim High?
***Powerschool Grades or Report Card Grades for each High Achievers are required***

***To complete enrollment, an invoice will be sent to your email for registration and first week tuition. All fees are non-refundable.***
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