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*** 2020 APPLICATION***
Afterschool/Summer Institute
Country
Address Line 1
City
State
Postal Code
PARENT/GUARDIAN INFO
First Name
Last Name
Country
Address Line 1
City
State
Postal Code
PERSONS (AGE 16 OR OLDER) AUTHORIZED FOR PICK UP OTHER THAN PARENT
EMERGENCY CARE INFORMATION
FINE ARTS SELECTION-NOW OFFERING BRASS!
1st Choice
2nd Choice

The Family Educational Rights and Privacy Act is a Federal law protecting student education records privacy. Parents have the right to inspect their child's records and request errors be corrected.

ACKNOWLEDGEMENTS
I understand that my child may be dismissed from the Afterschool/Summer Institute as a result of continuous discipline problems.
I agree that the program operator may authorize the doctor of their choice to provide emergency care if I nor the family doctor can be contacted.
I give permission for use of my child's photo and/or likeness in media related to the Afterschool/Summer Institute.
Scholarship Request
If Applying for Scholarship, Income Verification Will Be Required.

***$25 APPLICATION FEE REQUIRED TO PROCESS***

Credit Card Information
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Amount
Your total payment will be

What We Do

Programs

Academics and the Arts are rooted in all we do. Check out our programs.
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Events

If beauty is in the eye of the beholder, BEHOLD our upcoming and past events!
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Volunteer

Want a closer brush with Charlotte CSA? Sign up to volunteer and we'll put your talents to good use.
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