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TAP (boys)
PALS (girls)
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Parents
Online Application
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Application
Select a program...
Boys 7th-10th Grade Program
Boys 3rd-6th Grade Program
Girls 7th-10th Grade Program
Girls 3rd-6th Grade Program
Select a semester ...
Fall Program
Spring Program
Summer Program
Date:
Attended YLF Program before?
Student Information
First Name:
M.I.:
Last Name:
Gender:
M
F Date of Birth (mm.dd.yyyy):
School Attending:
Grade Level (Entering Fall 2010)
School Type:
Choose ...
Public
Public Charter
Private
Christian/Catholic
Avg. Academic Grade (B+, C-, etc)
Ethnicity (optional):
Religion (optional):
Address:
Apt/Suite:
City:
State:
DC
MD
VA
Other
Zip:
Mother's Name:
Father's Name:
Mother Living at Home?
Y
N Father Living at Home?
Y
N
Languages Spoken at Home (other than English):
Siblings (Name, Age):
1.
4.
2.
5.
3.
6.
Primary Contact
(Parent or Guardian)
Name:
Relationship to Student:
Home#
Work#
Cell#
Email:
Confirmation email will be sent here.
Employer:
Secondary Contact
Name:
Relationship to Student:
Home#
Work#
Cell#
Email:
Occupation:
Financial Aid
Financial Aid Needed?
Yes
No
Note: you only need to complete the Financial Aid section if you choose "Yes"
# of People in Household:
Annual Household Income:
Other Siblings in YLF Programs: # in TAP
# in PALS
School Contact Info
Please provide the name (and contact info, if you have it) of a teacher, counselor or school administrator who knows your child well who can give us good insights into your child's strengths and weaknesses.
Contact Name:
Position:
Phone:
Email:
Miscellaneous
How did you hear about us?
Primary reason for enrollment in YLF Program:
