UES Activity Form Session 3 2015 (2)

1 Park Street Montpelier, Vermont 05602 802-225-8259 Session 3 January 5 – February 21, 2015 Check your choice of program. Pick one program each day your child attends. Monday □ Outdoor Adventure 3-5 (Limited 13) □ Soap Carving 2-3 (Limited 13) □ Poetry 2-5 (Limited 13) Tuesday □ New Board Games 2-5 (Limited 13) □ Let’s form a Team! 2-5 (Limited 13) □ Español Para Todos 2-5 (Limited 13) Wednesday □ Outdoor Survival 2-5 (Limited 13) □ Discovering Who We Are 3-5 (Limited 13) □ Latin America 2-5 (Limited 13) Thursday □ Español Para Todos 2-5 (Limited 13) □ Vermont Animals 2-3 (Limited 13) □ Gym-Time 2-5 (Limited 13) Friday □ Soap Carving 3-5 (Limited 13) □ Ultimate Survival 2-5 (Limited 13) □ Gym-Time 2-5 (Limited 13) Activity Informat ion Community Connections Union Community Connections Union Elementary School After School Program Diadel Ortiz-Program Director 225-8259 [email protected] Child’s Name____________ Teacher/grade___________________________ Parent_________________________________ Daytime phone#__________ Attends: M, T, W, Th, F Email: Sliding scale fee per day: $ 10-$17 Payment is due in full for the whole course. Unless you have made other arrangements and they were approved by the Director. Monday 6x______________=$ Tuesday 7x______________=$_ Wednesday 7x____________=$_ ______________ Thursday7x______________=$_______________ Friday 7x______________ __=$____________ □ Cash enclosed- Amount: $ __________ □ Check made out to: UES CC-WCSU Amount: $_________________ □ Call us regarding financial help.

Documents

UES Activity Form Session 3 2015 (2)