REGISTRATION

FOR

2010 SUMMER SUCCESS IS NOW CLOSED

IMPORTANT NOTES:

  Due to popular demand for the Summer Success Program, last year classes filled up one week prior to the registration date which resulted in some students not being able to attend. 

Registrations are accepted on a first-come, first-served basis. 

Registration may either be completed on-line or in person.


Items denoted with a red asterisk * are required.
Summer Success 2010 Registration
 
June 21nd through July 17th
Agua Fria High School Campus
 * Student Name
 
First Name
M.
Last Name

First Name / Last Name
 * Home Address
 
Address 1
Address 2
City
State
Zip Code
 * Home Phone
 
 -  - 
(XXX)-XXX-XXXX
 * Cell Phone
 
 -  - 
(XXX)-XXX-XXXX
 * Email Address
 
 * School District
 
 * Currently Attending
 

If your school is not listed please type the name below.
Current School
 
 * High School Registered to Attend
 
Special Services
 

Have you ever received special services or attended specialized classes while attending your middle school?
If Yes, Please describe
 
Student Signature
 
Parent Signature
 
 * Date
 
Click to View Date Picker
Acknowledgement
 


By entering names and dates, I acknowledge this to be our signatures and authorize enrollment into the 2009 Summer Success Program
Additional Comments
 

You must be registered at a high school within the Agua Fria Union High School District to be eligible to attend. Transportation is provided for students attending summer programs at the Agua Fria Union High School District UNLESS they reside within the walk zone (1 1/2 mile) of the Agua Fria High School. Please note if your student participates in the English Learner Program and tests below English proficient as measured by AZELLA, your student will be considered for placement in the Summer English Language Development Program. You will receive additional information regarding pre program informational session for parents and students, transportation, program guidelines and class information. For more information please contact Ms. Robyn Jacobs 623-932-7106.
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