Summer Academy Information Form | Atlantic Street Center

If you are interested in learning more about Summer Academy, please fill out the form below for your child. Include as much information as possible. If you have any questions, please contact Tiffany Victory, Program Coordinator at tiffanyv@atlanticstreet.org.

Please note that completion of this form is not registration for Summer Academy 2023. This form lets Atlantic Street Center (ASC) know of your interest. An ASC Summer Academy staff member will reach out with more information and the official registration form.

Child's Name(Required)

First Last

Child's Birth Date(Required)

Name of Parent/Guardian(Required)

First Last

Parent/Gaurdian Email Address(Required)

Parent/Guardian Phone Number(Required)

Additional Parent/Guardian Name

Optional

First Last

Additional Parent/Guardian Email Address

Additional Parent/Guardian Phone Number

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

What grade will your child have COMPLETED at the end of this current school year (June 2024)?(Required)

Example: If your child is in 5th grade in April 2024, then you would put that they will have completed 5th grade.

What school does your child attend?(Required)

This should be the school they will be attending at the close of this current school year.

What is your child's Seattle Public School Student ID Number?(Required)

At this time, we can only enroll children with current Seattle Public School Student IDs.

Would you like to provide information for a second child?

Yes

If not, please submit your form.

Second Child's Name(Required)

First Last

Second Child's Birth Date(Required)

What grade will your child have COMPLETED at the end of this current school year (June 2024)?(Required)

Example: If your child is in 5th grade in April 2024, then you would put that they will have completed 5th grade.

What school does this child attend?(Required)

This should be the school they will be attending at the close of this current school year.

What is your child's Seattle Public School Student ID Number?(Required)

At this time, we can only enroll children with current Seattle Public School Student IDs.

Would you like to provide information for a third child?

Yes

If not, then submit your completed form.

Third Child's Name(Required)

First Last

Third Child's Birth Date(Required)

What grade will your child have COMPLETED at the end of this current school year ( June 2024)?(Required)

Example: If your child is in 5th grade in April 2024, then you would put that they will have completed 5th grade.

What school does this child attend?(Required)

This should be the school they will be attending at the close of this current school year.

What is your child's Seattle Public School Student ID Number?(Required)

At this time, we can only enroll children with current Seattle Public School Student IDs.