2025 Summer Learning Program

Step 1: Tell us about yourself.

Note: If you are completing this form for a program applicant, please provide the applicant's full name in the form fields and include your full name in the "Anything Else..." text box below.

First name

Last name

Phone

Grade Level

What Subjects Are You (Or Your Child) Seeking Support In?

Learning Challenges & Program Goals

Please tell us about the specific challenges you (or your child) are encountering and the goals you (or your child) wish to work towards. The more detail you provide, the better we can tailor our services to meet your needs.

How Often Would You Like To Attend Your Group Sessions?

Biweekly Sessions (6 total sessions)

Weekly Sessions (12 total sessions)

Other

Anything Else We Should Know?

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