SY25-26 After-School Plus (A+) School Program Registration Form Logo

  • After School Plus (A+) Program Registration Form

    For Summer 2025 and School Year 2025-2026

  • Child 1 Information

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  • Child 2 Information (if Applicable)

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  • Child 3 Information (if Applicable)

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  • Household Information

  • Parent/Guardian 1 Information

  • Parent/Guardian 2 Information

  • Authorized Pickup List

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  •  A+ Registration Information

    After School Plus (A+) Program Registration Form For Summer 2025 and School Year 2025-2026 The After-School Plus (A+) Program is the first of its kind in the nation, offering statewide after-school services to public elementary students at affordable rates. The program addresses the 'latchkey' child problem by providing high-quality after-school care for children of working parents or legal guardians, or for children whose parent or legal guardian is engaged in job training or attending school during A+ operation hours. If your child qualifies and you wish to enroll them, please complete this registration form and return it to your child's school.

    Fee: Due Monthly
    The monthly fee covers regular program activities. The fee will be adjusted for those who qualify if acceptable supporting documentation about their income or DHS 728 Form is submitted.

    Hours: After school - 5:30 p.m.
    The program hours are from after school to 5:30 p.m. on regular school days. The program will not operate during school vacations, state holidays, weekends, Teacher Institute Day, Teachers' work day and school half days.

    Supervision: Staff to Student Ratio of 1:20
    At each school, the staff will consist of a Site Coordinator and a group leader team supported by aides to maintain a staff to student ratio of 1:20. Staff recruitment may limit the number of students that a school can serve.

    Activities: A variety of scheduled activities
    Children usually begin the afternoon with free play time and a snack period (children bring their own snacks from home This period is followed by other activities including homework time, enrichment and physical fitness. Site Coordinators will have the flexibility to adapt scheduled activities to meet the conditions at your child's school.

    Eligibility: K-6 public elementary school latchkey children
    Your child is considered latchkey if he/she is living with you and during the hours of A+ operations you are employed, attending school, engaged in a job training program, or working as an employee of the A+ program. A parent/legal guardian who is "self-employed" must verify their status by: a) Submitting a copy of their general excise tax license; and b) submitting a copy of one of the following: 1) income tax return for the past year including Schedule C; or 2) printed business check.

    Starting Date: Child's first full day of school
    The starting date for your child is usually the first full day of school. However, the starting date of the A+ Program at your child's elementary school may depend on the after-school enrollment of at least 20 children and the ability to recruit necessary staff.

  • Parent/Guardian 1

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  • Parent/Guardian 2

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  • Parent/Guardianʻs Responsibilities and Agreements

    I certify that I am eligible for the A+ Program because I am working, job training, and/or attending school during the hours of A+ operations. I further certify that the information I have provided on this application form is correct and I hereby authorize the HIDOE and its contracted private providers to contact the appropriate parties to verify this information. | understand that changes on this registration form must be given to the A+ Site Coordinator in writing by the parent/legal guardian. Registration in the A+ Program is pending completion of this application and approval of the Site Coordinator.
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  • Parent/Guardianʻs Responsibilities and Agreements

  • Parent/Guardianʻs Billing and Fee Agreements

  • I understand and agree to abide by the above parent responsibilities and billing procedures provided in the A+ Parent Handbook. I understand and agreethat my failure to do so may result in termination of my child(ren)’s enrollment in the A+ Program

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  • After School Plus (A+) Program Emergency Form - Child 1

    Please complete this form for each child registering for the After School Plus (A+ Program)
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  • Parent/Guardian 1

  • Parent/Guardian 2

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  • Emergency Contacts

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  • If my child needs to be taken to an emergency facility, he/she will be taken to the nearest one. I give my consent for school authorities to take appropriate action for the safety and welfare of my child. I confirm that the information provided on this form is accurate and up to date. I understand that it is my responsibility to notify the school of any changes to my child's emergency contact or medical information.

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  • After School Plus (A+) Program Emergency Form - Child 2

    Please complete this form for child 2 (if applicable). Each child registering for the After School Plus (A+ Program) needs to complete this Emergency Form (one per child).
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  • Parent/Guardian 1

  • Parent/Guardian 2

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  • Emergency Contacts

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  • If my child needs to be taken to an emergency facility, he/she will be taken to the nearest one. I give my consent for school authorities to take appropriate action for the safety and welfare of my child. I confirm that the information provided on this form is accurate and up to date. I understand that it is my responsibility to notify the school of any changes to my child's emergency contact or medical information.

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  • After School Plus (A+) Program Emergency Form - Child 3

    Please complete this form for child 3 (if applicable). Each child registering for the After School Plus (A+ Program) needs to complete this Emergency Form (one per child).
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  • Parent/Guardian 1

  • Parent/Guardian 2

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  • Emergency Contacts

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  • If my child needs to be taken to an emergency facility, he/she will be taken to the nearest one. I give my consent for school authorities to take appropriate action for the safety and welfare of my child. I confirm that the information provided on this form is accurate and up to date. I understand that it is my responsibility to notify the school of any changes to my child's emergency contact or medical information.

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