Supplemental Special Education Enrollment

Enrollment for 2021 Winter Session: January 11-February 19, 2021

Please complete and submit this form to enroll your child for slot in Supplemental Special Education at Building Connections. A $50 deposit is required to reserve a spot in the class. After submission, we will reach out to you to go over next steps.

**If you have already registered your child for any class or camp at Building Connections in the past, you may use the Supplemental Special Education Re-Enrollment form instead!**

Child's Information


Parent 1 Information

Parent 2 Information

Emergency Contact Information


Child's Medical Information

Child's Behavioral Information

Kindergarten/1st Grade Only: Time Slot Preference

Payment Details
A deposit is required upon registration to guarantee you a spot in the upcoming class schedule. This amount is put toward the total payment for the classes.

Total $ 0