P.A.R.K.'s Prospective Student Information Request

Prospective Student Information Request

Please complete the information below to stay updated with the latest happenings at P.A.R.K. and to have P.A.R.K. staff reach out to you once your child become eligible for entry into our program.
Prospective students are current 5th and 6th graders who are already showing themselves as potential future P.A.R.K. students. (Current 7th graders who are outside of our October-March recruitment window may also be considered a prospective student.) Those on the Prospective Student list will receive occasional information and updates regarding the P.A.R.K. program. They will also be contacted once they reach the timeframe where they are eligible to officially apply for the program.

Please Note: To be eligible to apply for P.A.R.K., students must:
- be currently in the 7th or 8th grade
- be enrolled in a partner LRSD or PCSSD middle schoool
- have between a 1.8 to 2.8 g.p.a. in their core subjects for 1st or 2nd nine weeks
- complete a nomination form (from either their school or using our digital link)
Name of Student*
Student's Current School *
Student's current grade:*
Date of Birth *
Example: 05/16/03
Gender:*

MaleFemale
Race
Ethnicity
Parent/Guardian(s) Name:*

First NameLast Name
Relationship to student*
Contact Phone Number*
Enter a valid phone number with area code.
Would you like to receive text communication?

YesNo
Email Address
example@example.com
Would you like to receive email communication?

YesNo
Mailing Address*

Street Address

Street Address Line 2/Apartment Number

CityState / Province

Postal / Zip Code
How did you hear about P.A.R.K.?*
If you selected "Other" for the previous question, please explain how you first heard about P.A.R.K.
Date
Please Note: By submitting this form, you are agreeing to receive email communications from P.A.R.K. using the information provided on this form.
For further questions or comments, you may contact P.A.R.K. at:

● 6915 Geyer Springs Rd, Little Rock, AR 72209

● Email: park@positivekids.org

● Work: 501-562-5223 ● FAX: 501-562-5877

● Check out our website: www.positivekids.org
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