PLEASE REMEMBER THAT ANY STUDENT WHO RECEIVES FREE OR REDUCED LUNCH DOES NOT NEED TO BE NOMINATED.

Those students will automatically be invited to register.  No students are guaranteed a spot. Registration will be first come/first served when registration opens in mid-March.

* 1. First Name of Teacher or Staff Member Making the Nomination

* 2. Last Name of Teacher or Staff Member Making the Nomination

* 3. E-mail Address for Teacher or Staff Member Making the Nomination

* 4. Student's First Name

* 5. Student's Last Name

* 6. Student's School

* 7. Student's Current Teacher

* 8. Student's Rising Grade (Sept 2017 Grade)

* 9. Primary Parent Contact First Name

* 10. Primary Parent Contact Last Name

* 11. Primary Parent Contact E-mail Address

* 12. Primary Parent Contact Phone Number

* 13. General Reason for Nominating Child for a school-based summer enrichment program

* 14. Please indicate at least one other school-based professional with whom you have discussed this nomination and who supports the nomination.

* 15. Do you have any other comments or other useful information about the importance of this child attending Co-Op this summer?

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