Application

Please fill out our online application or download a PDF.

Community Learning Center of Southwest Florida Summer Academic Enrichment Program 2010

Please complete the enrollment application and click submit. Your application will be reviewed and a representative from Community Learning Center will contact you within 24 business hours. Thank you

If you desire to register multiple students please complete a separate application for each.

Section 1: Parent Information
 * required fields

First Name: *
Last Name: *
MI:
Address: *
Apt.#:
City: *
State: *
Zip Code: *
Work Phone:
Home Phone: *
Mobile Phone:
Email Address:
Contact Preference  Phone
Email

Section 2: Student Information

First Name: *
Last Name: *
MI:
Last School Attended: *
Last Grade Completed: *
Does student have any diagnosed learning disabilities: Yes No
If yes, please explain:
Did student pass to next grade for the 2010/2011 school year? Please check one. Yes No
 Subject Area you wish to have your child tutored in: please only select one
Reading Skills Math Skills Testing Skills
Phonemic Awareness Mathematics (basic skills) FCAT Prep
Reading Comprehension/Fluency Algebra/Geometry ACT/SAT Prep
Language Arts/Grammar/Writing Trigonometry/Calculus  
     

Section 3: Enrichment Packages

Package A
Students receive twenty (20) hours of sessions in one subject over seven (7) weeks. Students will work from a specially designed lesson plan based on their personal academic needs. This package provides the student with more time to grasp the skills that are essential for improving in areas they may be struggling in or desire to have an advantage in..
Total cost: $340.00

Package B- Accelerated program
Students receive twenty (10) hours of sessions in one subject over three (3) weeks. Students will work in a small group of three to five students. Students attend 1 session weekly. This package allows for the student to have a refresher course in the chosen subject. Registration for Package B ends October 30, 2010.
Total cost: $170.00

For security purposes, please enter the 4 digit code at the right of the box. Your form cannot be processed without this code.

 8473