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Summer Reading Intervention Cohort Registration

Starts Tuesday, June 3; meeting three days a week for eight weeks

Early bird discount: $1,250 (if signup by March 31)
Regular price: $1,400 (starting Apr. 1)

Parent/Guardian Information

Preferred Communication Method

Child Information

Date of Birth
Grade Level Completed in the Most Recent School Year

Program Preferences

Rank your Preferred Session Time
Rank your Preferred Session Location
Are you able to Commit to the Full 8-week Program Schedule?
Yes
No

Health and Safety

Learning Needs and Interests

Does your Child Receive any Services, Support, or have any Other Diagnosis? (Check All That Apply)

Note: A diagnosis is not required for reading cohort participation.

Permissions and Payment

Do you give permission for your child’s photo to be taken for promotional purposes?
Yes
No
Will you be using EFA funds for payment?
Yes
No

Additional Feedback

How did you hear about this summer reading program?

Products

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