After School Study Hall form

After School Study Hall Form

Junior High Students are required to be in Study Hall if they are on campus after 3:15 p.m.High School Students are required to be in Study Hall if they are on campus after 3:30 p.m.

Student Information
Complete for at least 1 student.
Student 1 Name:*
Student 1 Grade
Student 1 Medical Concerns: *
Student 2 Name:
Student 2 Grade
Student 2 Medical Conerns:
Student 3 Name:
Student 3 Grade
Student 3 Medical Concerns:
Grade Level and Rate*

Grades 6-8 3:15-6:00 PM $150/month; $15/dayGrades 9-12 3:30-6:00 PM $150/month; $15/dayDrop In ONLY
Drop-In Rate: Drop-in rate is $15 a day.

Late Fee: For students who are picked up after 6:00 pm, there is a charge of $15.00 for the first 5 minutes and $1.00 for each additional minute.

Discount: Families who enroll more than one child in BAC and/or After School Study Hall receive a 10% discount.

Early Release: ASSH is open for most Early Release days. There is no charge until 3:00. After 3:00, the charge is $15.00 per hour for drop-in students. No ASSH on the last day of each semester (December and May
Parents' Names: *
Email:
example@example.com
Study Hall Start Date*

MonthDayYear
Date
Cell Phone:*
Work Phone*
Allergies:*

After School Study Hall Form