Student Information

Thank you for your interest in signing your student up for Middleburgh Central School District's After School Program for Elementary and Jr./Sr. High School Students AND/OR the High School Tutoring Program. Please begin the online registration process by completely filling in the information below for your STUDENT.

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* 1. Grade Currently Enrolled (Grades 3-12 only)

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* 2. Student's Last Name

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* 3. Student's First Name

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* 4. Student's Gender

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* 5. Home Phone Number

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* 6. Student's Full Address (Street, City, State, Zip Code)

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* 7. Insurance Card Number

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* 8. Doctor's Name

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* 9. Doctor's Phone Number

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