Please complete and submit this form and an OPEN EDvantage Consultant will contact you to discuss our summer services or you can schedule a meeting on the Calendar.

NOTE: your spot is NOT confirmed until payment is submitted (see Step #2 Below)

Parent First Name *

Parent Last Name *

Email *

Phone *

Student First Name *

Student Last Name *

What school will your student attend next year? *

What English class will your student take next year? *

What grade will your student be in next year? *

Any additional information you think we should know? (IEP, 504, ADHD, interests)