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Extended Student Services (ESS) Wait List Form

ESS Family Information and Waitlist Form

Please complete the form below. As space becomes available, a program coordinator will contact you.

Parent 1

Parent 2

Please list all children below:

Child #1

Child #2

Child #3

Child #4

General Information

Tuition assistance is based on a sliding scale.

Your application will be dated upon receipt and you will be contacted when there is an opening at your home school site or the school your student is currently enrolled in.
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