After School Safety Check

2. After SchoolSafety Check is a telephone reassurance program. This service is designed to assist parents in confirming that their child has made it home from school safely.<br><br> To enroll in this free service, please complete this application and submit. Your information will be kept confidential and will not be used for purposes other than the After SchoolSafety Check.

   After SchoolSafety Check is a telephone reassurance program. This service is designed to assist parents in confirming that their child has made it home from school safely.
   
   To enroll in this free service, please complete this application and submit. Your information will be kept confidential and will not be used for purposes other than the After SchoolSafety Check.

4. Name*

6. Address*

8. Phone Number*

   This is the number we will call each day.

9. Tell us what time of day you wish to be called*

   Up to 8 p.m.

13. Contact Information: (Please provide your contact numbers)

15. Name*

16. Phone 1*

18. Phone 2

19. Phone 3

21. Email*

Leave This Blank:


22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

* indicates a required field