2026 ASU ASPIRE Summer Camp Application

2026 HEAD START SUMMER CAMP
Thank you for your interest in the ASU ASPIRE Head Start Summer Camp for grades 5-12.

Dates: June 8-25, 2026

Monday-Thursday | 8 am - 1 pm

Location: Alabama State University

Cost: $250.00

In-person Payments:

If you would like to pay by check or cash, please monitor your email on when you can drop off payments to the ASPIRE office.

Online Payments: https://www.alasu.edu/giving

(1) Under choose amount, type the camp registration fee of $250 (2) Under gift designation, please select ASPIRE (3) Enter your basic information (4) Enter your credit card information to submit payment

CONTACT INFORMATION: (334) 604-5371 | cjhandy@alasu.edu | slbarnes@alasu.edu

Open house date will be emailed to all parents soon.
STUDENT INFORMATION
Student Name*

First NameLast Name
MaleFemale
Student's Date of Birth*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
56789101112
School*
Subject(s) your child needs help in the most.
PARENT INFORMATION
Primary Contact Name*

First NameLast Name
MotherFatherGrandparentOther
If other selected above, please explain:*
Primary Contact Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Contact Name*

First NameLast Name
MotherFatherGrandparentOther
If other selected above, please explain:*
Secondary Contact Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Both ParentsMotherFatherSplit Custody (Mother & Father)GrandparentOther
If other selected above, please explain:*
ASPIRE WebsiteASPIRE Social MediaAlabama State UniversityFriendOther
Parent Signature*
Should be Empty:

2026 HEAD START SUMMER CAMP

STUDENT INFORMATION

PARENT INFORMATION