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REGENTS ASSISTANCE PROGRAM APPLICATION: December 3rd 2022 – January 23rd 2023

*Please note, required fields are in red.

Please return this page to the high school main office no later than Thursday, December 1st, 2022.

Weekday Schedule: 3:00 – 4:10 P.M.

(Pick one course per day where necessary)

(Pick one course per day where necessary)
(Pick one course per day where necessary)
(Pick one course per day where necessary)
My son/daughter has permission to register for the above class/classes as part of the Regents Assistance Program.
Student Signature
Grade
Required Parent Signature
Contact Number