Application Form

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Please list three days/times on which you would be able to bring your child to Missouri State for a screening and placement consultation:

Example:

1st choice: Monday from 8 a.m. to 9 a.m.,
2nd choice: Wednesday from 4 p.m to 5 p.m.
3rd choice: Saturday from 9 a.m. to 10 a.m.


Days and Times child is available for participation in program:
Typically activity sessions meet for one hour twice a week, Monday through Saturday.
Please specify the days (Monday – Saturday) and times (8 a.m. through 7:00 p.m.) that your child is available for participation in the program.
 

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