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Roosevelt After School Program

REGISTRATION

Fill out the form below and we will contact you to complete the registration process. In Message Box Please State:

  • Parent/Guardian Name

  • Student Name/Age/Grade/

  • Student's Teacher & Classroom

  • Choice of Mondays, Wednesdays or Both

  • Contact Phone Number

  • Request Scholarship Application if needed

Registration is on a first come, first serve basis.

Success! Message received.

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Call 

805-455-1124

Email

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