Skip to content
About Us
Our History
Leadership
Board of Directors
News
Our Impact & Financials
Parents
Programs
Early Learning Program
Afterschool Program
Summer Camp
Teen Program
Family Support
Give
Get Involved
Volunteer
Alumni
Careers
Events
About Us
Our History
Leadership
Board of Directors
News
Our Impact & Financials
Parents
Programs
Early Learning Program
Afterschool Program
Summer Camp
Teen Program
Family Support
Give
Get Involved
Volunteer
Alumni
Careers
Events
Contact
Donate
Parent Interest Form
Parent / Guardian Information
Parent/Guardian Full Name
First
Last
Phone
Email
Preferred Method of Contact (Phone, Email, Text Message)
Preferred Language (English, Creole, Spanish)
Child Information
Child’s Full Name
(Required)
First
Last
Child's Date of Birth
(Required)
Add Additional Child
Yes
Child’s Full Name
First
Last
Child's Date of Birth
Add Additional Child
Yes
Child’s Full Name
First
Last
Child's Date of Birth
Add Additional Child
Yes
Child’s Full Name
First
Last
Child's Date of Birth
Programs of Interest
Please select all programs you are interested in learning more about.
(Required)
Early Learning Program, ages 12 months to 5 years
Out-of-School (afterschool), ages 5 to 18
Summer Camp, ages 5 to 18
Teen Program, ages 13 to 18
Family Support Services
Financial Assistance Information
Do you currently receive any of the following?
(Required)
Early Learning Coalition (ELC) School Readiness
Voluntary Pre-Kindergarten (VPK) Voucher
Headstart
Currently applying for assistance
None of the above
Would you like information about scholarships, tuition assistance, or reduced-cost program options?
Yes
No
After you submit this form, a team member will contact you to answer questions, discuss next steps, and help you explore the best fit for your child.
Scroll to Top
We’re grateful for your partnership in helping children and families thrive.
About Us
Our History
Leadership
Board of Directors
News
Our Impact & Financials
Parents
Programs
Early Learning Program
Afterschool Program
Summer Camp
Teen Program
Family Support
Give
Get Involved
Volunteer
Alumni
Careers
Events
Contact
Donate
