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THE LEVITTOWN AFTER-SCHOOL PROGRAM
IMPORTANT INFORMATION

Applications received after 8/15/16 will be considered for a 9/9/16 start date.

In order to provide a safe and affordable child-care setting after school hours, the Levittown Public School District offers an after-school program. LAP, the Levittown After-School Program, is open to students who are entering kindergarten through grade 6 in September, who reside in the Levittown School District and who attend the Levittown Public Schools.

The program is housed in all six of our elementary schools. Some basic information follows:

  • The program will begin on Thursday, September, 8th 2016
  • The hours are from 3:30 to 6:00 PM each day school is in session. When extreme weather conditions cause after-school activities to be cancelled, the Levittown After-school Program hours will be from 3:30 - 4:30 pm. It is important to note that the 4:30 pick up time will be strictly enforced.

The fee schedule for the program is as follows:

  • Five-day program $150 for the first child $90 for each additional child per month
  • Three-day program $100 for the first child $60 for each additional child per month
  • Payment for September will be accepted the first week of the program. Payment for subsequent months is due before the start of each month.

Children attending LAP have an opportunity to work on their homework independently under adult supervision. They participate in organized activities inside or outside weather permitting. They have coloring/crafts and board games available. Snack and a drink are provided daily.

The program is available to sixth grade students. These children stay in their respective middle schools until 3:45. During that time, they may participate in school clubs or complete homework in the after-school homework club offered by the middle schools. At 3:45 students are bused to Gardiners Avenue Elementary School.

Following is some important information about registration for the program:

  • We require two names for emergency contact. It is imperative that we have the names of people who live locally and are available from 3:30 until 6:00 PM to respond in the event of an emergency. Please supply your emergency contact people with the last four digits of your social security number or a 4 digit pin code. This will be used as an identification code for contact purposes only.

If you have any questions or concerns, please call the LAP office at 516-520-8491 between the hours of 9:00AM and 6:00 PM. If no one is available, leave a message and your call will be returned as soon as possible. The LAP office is closed during the summer. For questions or for more information over the summer, please contact Mr. James Centonze at (516) 520-8491.




THE LEVITTOWN AFTER-SCHOOL PROGRAM
REGISTRATION FORM
THE LEVITTOWN A.M. PROGRAM
IMPORTANT INFORMATION

In order to provide a safe and affordable child-care setting prior to school hours, the Levittown Public School District offers a before-school program. LAMP, the Levittown A M Program, is open to students who are entering kindergarten through grade 5 in September and who reside in the Levittown School District and who attend the Levittown Public Schools. The program is housed in all six of our elementary schools. Some basic information follows:

  • The program will begin on Thursday, September 8rd, 2016.
  • The hours are from 7:10 AM to 9:00 AM each day school is in session.
  • Please be advised that there is no adult supervision prior to 7:10 AM, and the schools are not open prior to 7:10 AM. All students must be brought into each building and checked in, at the door, with the teacher in charge.
  • The fee for the program is $100 per child per month.
  • Payment for September will be accepted the first week of the program. Payment for subsequent months is due by the fifth school day of each month. Please make your check payable to Levittown Public Schools, or you may pay on Pay-Schools. A $10 late fee will be charged after the 5th school day of each month. A $20 late fee will be charged after the 10th school day of each month.

Following is some important information about registration for the program:

  • When completed, please return all forms to the Levittown Public Schools Department of Instruction, 150 Abbey Lane, Levittown, NY 11756 by August 1. Any applications received after August 1st will only be accepted if space is available.
  • Faxed copies of the LAMP application will not be accepted.
  • Please note that we are asking for two names for emergency contact. It is imperative that we have the names of people who live locally and are available from 7:10 AM to 9:00 AM to respond in the event of an emergency. Please supply your emergency contact people with the PIN number you provide on this application. This will be used as an identification code for contact purposes only.

If you have any questions or concerns, please contact Mr. Gattus at 434-7418. If no one is available, leave a message and your call will be returned as soon as possible.


THE LEVITTOWN A.M. PROGRAM
REGISTRATION FORM
* = Required Fields
(1) PROGRAM INFORMATION
SCHOOL YEAR*



START DATE*



PROGRAM SCHOOL ATTENDING*

NUMBER OF DAYS ATTENDING PROGRAM*


WHICH DAYS?*
(2) STUDENT INFORMATION
FIRST NAME*

LAST NAME*

DATE OF BIRTH*
Select a date from the calendar.
GENDER*

HOME PHONE*

ADDRESS*



TOWN*

STATE*

ZIP*

GRADE IN SEPTEMBER*

(3) PARENTS INFORMATION
FATHERS INFORMATION
FIRST NAME*

LAST NAME*

CELL PHONE*

WORK PHONE*

SOCIAL SEC. #*
XX-XX-
(LAST 4 DIGITS)

MOTHERS INFORMATION
FIRST NAME*

LAST NAME*

CELL PHONE*

WORK PHONE*

SOCIAL SEC. #*
XX-XX-
(4 DIGITS)

Note: The last four numbers of your Social Security number or 4 digit pin code will be used as a code for identification purposes only. Please be sure your emergency contact person knows this identification number.

(4) EMERGENCY CONTACTS

You must provide at least 2 emergency contacts that live within 5 miles of the program site your child attends.

EMERGENCY CONTACT 1
FIRST NAME*

LAST NAME*

PHONE*

ADDRESS*



TOWN*

STATE*

ZIP*


EMERGENCY CONTACT 2
FIRST NAME*

LAST NAME*

PHONE*

ADDRESS*



TOWN*

STATE*

ZIP*

(5) MEDICAL EMERGENCY INFORMATION
PHYSICIANS NAME*

PHYSICIANS PHONE*

MEDICAL PROBLEMS (Allergies, medications, physical limitations, ect. Please list all that apply.)

MEDICAL INSURANCE CARRIER*

MEDICAL INSURANCE CARRIER PHONE*

MEDICAL INSURANCE ID*

I, ___________, give permission to the Teacher-in-charge of the Levittown After-school Program to administer minor first aid only (apply sterile bandages to cuts and ice to bumps) to my child, ___________.

In the event of a medical emergency, if I or the emergency contact persons I have listed cannot be reached, I authorize the Teacher-in-Charge of LAP to take the necessary steps to provide medical treatment for my child including authorizing emergency medical treatment at a hospital.


Please check if child is over 55 pounds.
(In the event that CPR must be administered, this information is needed.)

PARENT / GUARDIAN DIGITAL SIGNATURE*

(Typing your name above will be accepted as a digital signature.)

DATE
____________

(6) ENROLLMENT AGREEMENT

First month’s tuition is payable before the end of the first week of the LAP Program in September.

Tuition payments are due the first of each month Payment via PaySchools is recommended. You can access the Pay Schools here: http://www.levittownschools.com/district/payschools/ Check or money order are the only other accepted forms of payment. Cash will not be accepted.

If tuition payments are NOT received by the 5th school day of each month, a $10.00 late payment fee will be added to my bill. After the 10th school day, a $20.00 late payment fee will be added.

PLEASE READ CAREFULLY
  • If my check is returned for insufficient funds, a fee of $10.00 will be added to my bill. If this happens twice, I will be responsible to pay by money order each month thereafter.
  • I must notify the LAP Program and classroom teacher of any changes to my child's after-school schedule. If my child will no longer attend, I must give the program advanced notice before the start of the next month.
  • Under no circumstances will my child be released to anyone without a phone call or written authorization from the parent/guardian. Proper identification is required to pick up children. No students will be released to anyone under 16 years of age.
  • LAP reserves the right to call the emergency numbers and arrange for someone to pick up children who appear to be ill, show signs of contagious illness, or if LAP has to close early, due to an emergency (this includes very heavy snowfalls).
  • I must inform LAP of any special needs, medical concerns or problems my child may have.
  • LAP has the right to exclude my child from the program if I do not meet the responsibilities of this contract.
  • LAP has the right to exclude my child from the program if proper behavior is not displayed.
  • All equipment and games are supplied by the LAP program. LAP will not permit students to bring in any items from home such as games, equipment, electronics, etc. . .
  • I am responsible for picking up my child by 6:00 PM or arranging for someone else to do so. This person must be able to provide the last four numbers of the parent's Social Security Number or 4 digit pin code. If I send someone to pick up my child, I must notify LAP in writing or by calling the program my child attends (9:00AM - 6:00 PM) and leaving a message. A late pick-up fee of $10.00 will be charged for every ten (10) minutes to those families who come after 6:00 PM. For example, 6:10 is $10.00, 6:20 is $20.00, 6:30 is $30.00 etc.
  • I have read and accept the Behavior Policy (link will open in a new window)

First month’s tuition is payable before the end of the first week of the LAP Program in September.

Tuition payments are due the first of each month. Payment is by check, money order, or through PaySchools only. You can access the Pay Schools site through the Levittown School District homepage or at http://www.levittownschools.com/district/payschools/

If tuition payments are NOT received by the 5th school day of each month, a $10.00 late payment fee will be added to my bill. After the 10th school day, a $20.00 late payment fee will be added.

PLEASE READ CAREFULLY

  • If my check is returned for insufficient funds, a fee of $10.00 will be added to my bill. If this happens twice, I will be responsible to pay by cash or money order each month thereafter.
  • Under no circumstances will my child be released to anyone without a phone call or written authorization from the parent/guardian. Proper identification is required to pick up children. No students will be released to anyone under 16 years of age.
  • LAMP reserves the right to call the emergency numbers and arrange for someone to pick up children who appear to be ill, show signs of contagious illness, or if LAMP has to close early, due to an emergency (this includes very heavy snowfalls).
  • I must inform LAMP of any special needs, medical concerns or problems my child may have.
  • LAMP has the right to exclude my child from the program if I do not meet the responsibilities of this contract.
  • LAMP has the right to exclude my child from the program if proper behavior is not displayed.
  • I have read and accept the Behavior Policy (link will open in a new window)

I have read this agreement carefully and agree to the contents.
PARENT / GUARDIAN DIGITAL SIGNATURE*


(Typing your name above will be accepted as a digital signature.)
(7) REVIEW STATUS COMMUNICATION

To keep track of the review process of this application it is necessary to supply us with your e-mail address. This e-mail address is not collected for any other purpose than to generate status e-mails regarding this application.

E-MAIL ADDRESS TO WHICH YOU'D LIKE TO RECEIVE STATUS UPDATES REGARDING THIS APPLICATION*

(8) Print A Copy (Optional)

Optionally - You may print a copy of this form for your records. Please remember to hit "Submit" to finalize your application.

(9) SUBMIT APPLICATION

Please Note:
Students may not attend the program until you receive a confirmation e-mail that this application has been approved.



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