H.E.L.P. PROGRAM REGISTRATION

By Melissa Fullerton July 27, 2016 15:31

Governor Mifflin H.E.L.P. Program

Students wishing to attend the H.E.L.P. Program will need to fill out the registration information below or click here to download a paper copy, print, and return to Ms. Dennis. Once this form is complete and a parent or guardian has provided an electronic or written signature, students are welcome to attend H.E.L.P. any day that it is offered. Students may stay in the program as long as they like and there is no attendance requirement.

Student Name:

First

Last

Date:

Day

Month

year

Grade:

Homeroom teacher:

Address:

Street Address City State / Province / Region Postal / Zip Code

Phone:

Area Code

Phone Number

Alt. Phone:

Area Code

Phone Number

Emergency Contact:

First

Last

Emergency contact phone number:

Area Code

Phone Number

Current medical conditions or allergies:

Transportation home:

Riding rim run bus

Walking

Being picked up

Driving

ELECTRONIC SIGNATURE REQUIRED

By checking the box below, I acknowledge that my child has received permission to attend the H.E.L.P. program.

Yes, I have given my child permission to attend the H.E.L.P. program

Parent/guardian:*

First

Last

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By Melissa Fullerton July 27, 2016 15:31

Address:
101 South Waverly Street
Shillington, PA 19607
Phone: 610-775-5089
Fax: 610-796-7471
Grades: 9-12

School hours for students:
7:35 a.m. –2:25 p.m.

School office hours:
School In Session
7:30 a.m. – 4:00 p.m. (M-F)

Summer
8:00 a.m. – 3:00 p.m. (M-F)

Upcoming Events

GMHS Marching Band Competition

October 23
ACT Exams

October 23
HS – SGA Meeting

October 24 @ 7:00 pm
HS – SGA Meeting

October 26 @ 3:00 pm
HS – ASVAB Exam

October 27 @ 7:45 am

View All Events

H.E.L.P. PROGRAM REGISTRATION

Upcoming Events

GMHS Marching Band Competition

ACT Exams

HS – SGA Meeting

HS – SGA Meeting

HS – ASVAB Exam

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