Webutuck Central School District
Summer School Enrollment Form



*Required fields.
I would like to enroll my son/daughter in the Summer School Program.
* Parent's First Name: 
* Parent's Last Name:  		 
 
* Child's First Name: 
* Child's Last Name:  		 
 
Address:
* Street: 
* Town: 
* Zip: 

* Phone
Home: 
Cell: 
Work: 






 Extension: 
* Complete Email: 
You will be contacted upon receipt of this form. If you have any further questions or concerns you may contact the HS principal at jposephn@wsd.dcboces.org