Lumos 2018-19 Vacation Workshops

Lumos 2018-19 Vacation Workshops
Choose Your Location: *

Newton, MA Lexington, MA Acton, MA
Choose Your Program in Newton, MA *
Choose Your Program in Lexington, MA *
Choose Your Program in Acton, MA *
What Skills Are You Looking For Your Child To Improve?

Speaking Confidence Critical Thinking Argument Constructing Persuasive Writing Critical Reading Impromptu Speaking Familiarity With Current Events
First Parent Name *

First Name Last Name
Contact Email *
example@example.com
Contact Phone *

- Area Code Phone Number
Second Parent Name

First Name Last Name
Contact Email
example@example.com
Contact Phone *

- Area Code Phone Number
What Town do You Live In? *
Student Name *

First Name Last Name
Student Date of Birth *

- Month - Day Year
Date
What grade is your child this current school year, 2018-19 *
What school will your child be attending next year?
Student Gender *

Male Female

Address *

How did you hear about us? *

From a Friend Google Search PTO email Camp Fair Guidance Counselor TimeOutNY Advertisement MommyPoppins Article Newspaper or Magazine Camp Directory
Who referred you?
Have you attended a Lumos program previously? *

Yes, Attended Summer Yes, Attended 2-day Workshop No
Has your child attended a debate tournament before? *

Yes No
Are there any students your child would like to be placed in the same class as?
What are your child's areas of interest or hobbies?
Do you have any additional information or requests for our staff?
Any allergies or health concerns our staff should be aware of?
Are there any locations you wish we had?
Emergency Contact

First Name Last Name
Emergency Contact Cell

- Area Code Phone Number
Please include two emails from teachers who would know what the student's classroom behavior and learning style are like. We will send these teachers a quick survey to help us tailor our teaching to your child's needs and interests.
Teacher 1 Email
example@example.com
Teacher 2 Email
example@example.com
Credit Card *

When you enter promo code, use ALL CAPS and make sure you click "Apply" to confirm the promo code

Workshop - 2 Day $ 80.00

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