Student Application Form - Spring 2026

Is {childsName} enrolled in any other after school activities/programs?

YesNo
If the answer is yes, please list any programs that might conflict with STAIR scheduling.
Please comment on any specific concerns regarding {childsName}.
i.e. Reading concerns, behavior, confidence, academic performance

Parent/Guardian Contact Name *

First NameLast Name
Parent/Guardian Relationship to Child*
Parent, Grandparent, Uncle, Aunt, etc.
Parent/Guardian Phone Number*
Parent/Guardian Email Address*
example@example.com
Parent/Guardian Address*

Street Address

Additional Street Address Information (Apt #, Location)

CityState / Province

Postal / Zip Code

Secondary Contact Name*

First NameLast Name
Secondary Contact Relationship to Child*
Secondary Contact Phone Number*
Secondary Contact Email Address*
example@example.com
How did you hear about STAIR?*

Friend or Co-WorkerChurchSchoolBack to School EventSocial MediaPrevious STAIR student or familyFlyerOther