School of Engineering and A

rts
Targeted Services
REGISTRATION FORM 2016
To:

Parents of students who qualify for Targeted Services

From:

Chad Belling, Targeted Services Coordinator, School Of Engineering and Arts

Plans for Targeted Services are underway. Students who qualify for Targeted Services (Math and
Reading) in grades 3-5 will receive additional tutoring two days a week from Dec 6 March 23.

There is no cost to this program. It is FREE!

Targeted Services is scheduled to begin on Tuesday, December 6, 2016.

The program will run two days a week, Tuesdays and Thursdays, at the School of Engineering and Arts.

Targeted Services classes will begin at 3:45 pm and will end at 5:00 pm.

Bus service will be provided at no cost for Targeted Services sessions, if needed.

To qualify for busing you must live in the district attendance area.

NOTE: Students are expected to follow the same SEA behavior expectations as during the day. Dismissal from the
program may occur if school-wide expectations are not followed.

If you have any questions please contact Chad Belling @ 763-504-7242

Please indicate whether or not your child will be participating in Targeted Services this year:

_____ My child will attend Targeted Services from December 6 March 23

_____ My child will not be participating in the Targeted Services program at SEA
(Please Print)

STUDENT AND PARENT INFORMATION

Student last name:

First:

Teacher Name:

Parent Name:
Primary Phone:

Emergency Contact Name:

Phone Number

TRANSPORTATION
How will your child be getting home from Targeted Services? (Please check one)
Bus

Adventure
Club

Parent Pick-up

PARENT PERMISSION
I authorize my child to attend Targeted Services at the School of Engineering and Arts

Date

PLEASE RETURN FORM BY FRIDAY, OCTOBER 28, 2016.

Grade: