Summer Enrichment Academy 2019

We are so excited! Next month we will be hosting our 18th Annual Summer Enrichment Academy.

A recent partnership will allow us to provide expert solutions for military dependents that are part of our Summer Enrichment Academy. There will be no out of pocket expenses for these services for those that are eligible.

Please take a few minutes to complete this brief survey to let us know a little information on your child(ren) so we can see if they are eligible for the Summer Enrichment Academy. If they have experience any of the statements or need help with any of the statements, please check the box. More than one selection is allowed. Please complete one survey PER child. All responses are confidential and are used to help us to determine eligibility. Once you complete the survey, you would not need to contact our office to check the status. We will contact everyone personally to inform them if their child(ren) qualifies for the Summer Enrichment Academy.

Survey deadline is May 30, 2019.

Question Title

* 1. Grade Child will be in August 2019?

K-1st

2rd-3rd

4th-5th

Question Title

* 2. Parent/Guardian's Current Military Status

Active

Inactive

Retired

None of the Above

Other (please specify)

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* 3. Is the Child's Insurance Carrier Tricare?

Yes

Other

Other (please specify)

Question Title

* 4. Coping with Being a Military Family

Dealing with Deployment

Dealing with Family Member with PTSD

Re-Connecting Properly as a Family After Deployment Ends

Adjusting to Relocating

Other (please specify)

Question Title

* 5. Focusing on Social Skills

Bullying

Anger

Making Good Decisions

Peer Pressure

Focusing

Building Self-Esteem/Confidence

Expressing Emotions Properly

Understanding How to Make Friends

Conflict Resolutions

Organizational Skills

Shy

Unassertive

Other (please specify)

Question Title

* 6. Coping with Medical Issues

Child Medical Diagnosis (Cancer, Asthma, ADHD, Arthritis, Heart Disease, etc.)

Parent Medical Diagnosis (Cancer, Arthritis, Heart Disease, Stroke, etc.)

Family Member Medical Diagnosis (Cancer, Asthma, ADHD, Arthritis, Heart Disease, Stroke, etc.)

Hospitalization of Child, Parent, or Loved One

Other (please specify)

Question Title

* 7. Coping with a Loss or Separation

Understanding Death

How to talk about Death

Coping with Death

How to Heal Properly from Death

Loss of Friendship

Family Member or Parent Incarcerated

Family Dealing with Deportation or Fear of Deportation

Other (please specify)

Question Title

* 8. Coping with Divorce/Separation

Understanding Divorce/Separation

Dealing with Divorce/Separation

Balancing Spending Time with Both Parents

Dealing with Bonus Parent(s)

Other (please specify)

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* 9. Why do you think your child would benefit from this camp?

Question Title

* 10. Parent/Guardian's Information

Name

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number