Name *

First Name

Last Name

Phone *

(###)

###

####

Parent/Guardian Name *

First Name

Last Name

I could participate in the following TAG Program cohort times: *

The more days you are able to select, the easier it will be to assign you to a cohort. Select all that apply.

Mondays, 5:30PM - 7:00PM (Feb-April 2025)

Wednesdays, 5:30PM - 7:00PM (Feb-April 2025)

Thursdays, 5:30PM - 7:00PM (Feb-April 2025)

Sundays, 4:00PM - 5:30PM (Feb-April 2025)

None of the above time slots work for me.