23/24 ENRICHMENT PROGRAM MAKE-UP CLASS Request Form

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Student's Name

First Name

Last Name

2

Parent Phone Number

3

Family E-mail

example@example.com

4

STUDENT'S CURRENT CLASS INFORMATIONInclude Day of the week & Grade Level your child attends.

MONDAY, 3rd Grade

5

DATE STUDENT WAS or WILL BE ABSENT:

6

I UNDERSTAND THAT THERE ARE NO MAKE-UPS FOR MISSED SCHEDULED MAKE-UPS.* This field is required.

7

I UNDERSTAND THAT THERE ARE NO ONLINE CLASSES AVAILABLE FOR MAKE-UPS.* This field is required.

8

First Time Requesting a Make-Up Class?* This field is required.

Yes

No

9

Second Time Requesting a Make-Up Class?* This field is required.

Yes

No

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MAKE-UP CLASS DAY OF PREFERENCE-LAST DAY TO ATTEND A MAKE UP CLASS IS 05/01/23Please choose at least 3

MONDAY------- (4-6 PM 3-4 Year Old Class & Kinder-5th Grade Classes Level I & II)

TUESDAY-------( 4-6 PM Kinder-8th Grade Classes Level III & IV) IMPORTANT NOTE: ONLY LEVEL III & IV Students Allowed

WEDNESDAY.--------(4-6 PM 3-4 year old & Kinder-8th Grade Classes Level I & II)

THURSDAY--------( 4-6 PM Kinder-5th Grade Classes Level III & IV) IMPORTANT NOTE: ONLY LEVEL III & IV Students Allowed

SATURDAY--------( 9-11 AM 3-4 year old & Kinder-8th Grade Classes Level I & II)

SATURDAY----------( 11:15 AM-12 PM Mommy & Me Class)

SUNDAY-------------(9:00-9:45 AM Mommy & Me Class)

FRIDAY----------------( 12:15-1 PM Mommy & Me Class)

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