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Home
ESY
ESY Registration
ESY Registration
ESY Registration - Transportation
ESY Program Registration
Step 1 of 3 - Parent Information
Your Name:
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Your Email:
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Your Main Phone #:
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Your Cell Phone #:
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Your Home Address:
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Your Employer (for emergency use only):
Company/Name:
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Employer Phone #:
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Step 2 of 3 - Emergency Contacts
Emergency Contact 1:
Contact Name:
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Relationship to Student
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Contact Main Phone#
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Contact Cell Phone#
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Emergency Contact 2:
Contact Name:
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Relationship to Student
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Contact Main Phone#
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Contact Cell Phone#
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Next
Step 3 of 3 - Student Information
Student Data
Student Name:
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Student Gender:
male
female
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Student Birthday:
Month...
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Day...
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31
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Year...
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Student Current School:
Select Current School...
Private Placement
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Aux Sable
Bonnie McBeth
Central Elementary
Charles Reed
Creekside
Crystal Lawns
Drauden Point
Eagle Pointe
Elizabeth Eichelberger
Freedom
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Indian Trail
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Lakewood Falls
Liberty
Lincoln
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Plainfield High School - Central Campus
Plainfield East High School
Plainfield North High School
Plainfield South High School
Ridge
River View
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Timber Ridge
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Wesmere
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Student Current Grade Level:
Select Current Grade...
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8th
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P-STEP
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Choose the program your child was recommended to attend during ESY:
Related Services Only
2 Day or 4 Day ESY program
Private Placement
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Will this student require transportation:
Yes, I need transportation
No, transportation is not needed
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You MUST click the SUBMIT button below to finish your registration.
All ESY applications will receive an email at the email address you listed above. Make sure to check your inbox and spam. If you do NOT receive an email immediately following the submission of your application, please contact your child’s school. All future communication about ESY will come to this email address.
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