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.

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

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

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

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* 4. Student's First Name

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* 5. Student's Last Name

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* 6. Student's School

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* 7. Student's Current Teacher

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

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* 9. Primary Parent Contact First Name

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* 10. Primary Parent Contact Last Name

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* 11. Primary Parent Contact E-mail Address

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* 12. Primary Parent Contact Phone Number

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

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

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* 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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