BGCMC- Oak Street Site After School Program 2022-2023
BGCMC- Oak Street Site After School Program 2022-2023
2022-2023 Oak Street After School Waitlist
Date
Date
/
MM
/
DD
YYYY
Time
Time
:
HH
MM
AM
PM
AM/PM
Parent's Name
Parent's Name
*
First
Last
Contact Phone
Contact Phone
*
-
###
-
###
####
Parent's Email
First Member's Name
First Member's Name
*
First
Last
First Member's Grade for 2022/2023
*
K
1
2
3
4
5
6
7
8
9
10
11
12
Second Member's Name
Second Member's Name
First
Last
Second Member's Grade for 2022/2023
K
1
2
3
4
5
6
7
8
9
10
11
12
Third Member's Name
Third Member's Name
First
Last
Third Member's Grade for 2022/2023
K
1
2
3
4
5
6
7
8
9
10
11
12
Fourth Member's Name
Fourth Member's Name
First
Last
Fourth Member's Grade for 2022/2023
K
1
2
3
4
5
6
7
8
9
10
11
12
Location
*
Marion
Newark
Milo-Grogan
J. Ashburn
RISE
South Side
Livingston
KIPP