• School Year 2026–2027 Youth Enrollment Survey

  • Congratulations! Your child has been accepted into one of the University Community Collaboartive's after school programs for the 2026 to 2027 school year. We are excited to welcome your family into the UCC.

    Please fill out this form to complete the enrollment process and secure your child's slot.

    If you have any questions about the enrollment process, please email UCC's Assistant Director Johannah Bennett.

  • Format: (000) 000-0000.
  • Would you like to opt in to reminders and updates from program staff via text message?*

  • By agreeing to receive SMS updates from the University Community Collaborative you consent to receive SMS updates and notifications regarding program dates, progress, and events. Message frequency varies. Standard message and data rates may apply. Reply HELP for support. Reply STOP to opt-out. You can read our Privacy Policy at https://www.uccollab.org/policies.

  • Please fill out the section below if you would like to provide contact information for a secondary contact for your child.

  • Format: (000) 000-0000.
  • Does your child have asthma?*
  • Does your child require the use of an inhaler (pump)?*
  • Does your child need an inhaler (pump) to be kept on-site at the UCC?*
  • Does your child carry an epi-pen?*

  • We recognize that the following questions collect sensitive information about you and your family. As we receive funding from the City of Philadelphia Office of Children & Families (OCF), we are required to collect these data.

    Your responses will be kept confidential and are used for reporting purposes and advocacy only!

  • Our family is involved with the Department of Human Services (DHS) or the Office of Children and Families (OCF).*
  • My child is involved in the juvenile justice system?*
  • My child has an Individual Education Plan (IEP) or Social-Emotional Learning/Behavioral Needs.*
  • Does your family receive any of these benefits (select all that apply)?*
  • What is the primary language spoken in your home?*
  • Would you or someone in your family like access to information about any of the following?

  • Please upload the enrollment forms here or email them to UCC Assistant Director Johannah Bennett at johannah@temple.edu
    ​

    PLEASE NOTE: Your student’s spot in the program is not guaranteed until the Enrollment Survey and all the required paperwork above is submitted. You will receive an enrollment letter once your child’s spot has been secured.

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  • I understand that my child will be participating in an after school program for high school-aged youth with the University Community Collaborative at Temple University.

    Once enrolled, my child will be eligible to earn a stipend up to $1,320 if:

    1. They submit all required signed paperwork.
    2. They attend program consistently and communicate regularly when they may be late or absent.
    3. They participate fully in program activities.

  • By signing below, I conesnt to my child pariticpating in programming with the University Community Collaborative during the 2026 to 2027 school year. I understand that my child will be present on the campus of Temple University during regular programming. I also consent to allow my child to attend pre-scheduled and communicated field trips to off-campus locations as part of the program experience.

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