STUDENT APPLICATION - Virtual Expanded Learning Program (After School Program)


Parent or Guardian

Parent or Guardian


   By initialing here, I understand and agree that this enrollment form only applies to enrollment in the virtual after school program and does not guarantee enrollment in the on-campus after school program once school resumes.

   By initialing here, I give permission for my son/daughter to be interviewed, photographed, and/or videotaped while participating in the Expanded Learning Program. I am aware there are times the program may be featured in news stories and reporters, photographers, and/or film crews from television, radio stations, and newspapers may wish to interview my son/daughter. I understand that such photographs, video recordings, and/or reports will be property of the Expanded Learning and may be used ONLY for the purpose of documenting or publicizing the Expanded Learning Program through print, web, and social media.

   By initialing here, permit my student to participate in after school surveys. I understand that my student is being asked to be a part of an Expanded Learning Program Student Survey, being administered through the Fresno County Superintendent of Schools. The survey will be given twice this school year, as a pre-survey in October and post-survey in May. This is a very important survey that will help us evaluate and improve the Expanded Learning program, which offers your child activities designed to promote academic achievement and the development of positive social and emotional skills.

I declare that I am the parent/legal guardian of the named student and the information on this three-page application is true and correct. I will notify the Expanded Learning Program if there are changes to any information stated in the application.

Parent/Guardian Signature

I would like a copy of this form sent to me at the following email address: