www.saturdayschool.org
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Academic tutoring and instruction with certified teachers in a nurturing and supportive environment
Curriculum is aligned with that of Montgomery County Public Schools
 Grades Kindergarten through 8 focus on reading, language arts and math. Kindergarten at
Paint Branch and Wheaton @ Loiederman MS
 Grades 9 through 12 focus on core subjects (English and Math); support for High School.
Assessments; SAT/ACT support
Montgomery County students in
Grades 1 through 12
Saturday mornings 8:30 a.m. to 11:00 a.m.
Breakfast provided at 8:00 a.m. at all centers except Sherwood
See calendar online at www.saturdayschool.org
A registration fee of $40 for FARMS /$70 for non-FARMS.
A payment plan is available and can be completed at registration.
(FARMS = Free and Reduced-price Meals System)
12 LOCATIONS
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Parents may register online at www.saturdayschool.org or in person at the center
their student will attend.
For online registration, please bring your child’s report card to the first tutoring
session. PayPal, Visa and MasterCard are accepted.
For registering at the centers, please bring your child’s report card to the
Center. Cash, checks or money orders (made payable to GBTLA or The George B.
Thomas, Sr. Learning Academy, Inc.) are accepted.
You may register your student any Saturday that
Saturday School is in session.
Call The Learning Academy Office at 301-649-8078
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Blair HS
Einstein HS
Gaithersburg HS
Kennedy HS
Magruder HS
Northwest HS
Paint Branch HS
Rockville HS
Sherwood HS
Springbrook HS
Watkins Mill hs
Wheaton @
loiederman MS
Transportation is provided
at Blair, Kennedy,
Magruder, and Wheaton
@ Loiederman Centers
The GBTLA Saturday School is an independent non-profit 501(c)(3) organization. Contributions gladly accepted.
copyright © 2015 George B. Thomas Learning Academy
The George B. Thomas, Sr. Learning Academy, Inc.
2015–16 STUDENT REGISTRATION FORM
Parents may register online at www.saturdayschool.org or in person at the Center their student will attend. A registration fee of $40 for students receiving
Free and Reduced-price Meal Services (FARMS) and $70 for non-FARMS is required in order to register. A payment plan is available at all Saturday
School sites and can be completed at registration. For registering at the centers, cash, checks or money orders are accepted. Please bring the student’s
report card to registration. For online registration, PayPal, Visa and MasterCard are accepted. Please bring the student’s report card to the first session.
I WOULD LIKE TO ENROLL MY CHILD IN THE SATURDAY SCHOOL CENTER AT:
_____ MONTGOMERY BLAIR HS
_____ ALBERT EINSTEIN HS
_____ GAITHERSBURG HS
STUDENT NAME:
LAST
_____ SPRINGBROOK HS
_____ PAINT BRANCH HS _____ W ATKINS MILL HS
_____ ROCKVILLE HS
_____ W HEATON HS
_____ SHERWOOD HS
@LOIDERMAN MS
_____ JOHN F. KENNEDY HS
_____ NORTHWEST HS
_____ MAGRUDER HS
HOME PHONE:
FIRST
MIDDLE INITIAL
MCPS STUDENT ID NUMBER (REQUIRED):
HOME SCHOOL:
MALE
GRADE:
FEMALE
DATE OF BIRTH:
ENROLLMENT DATE:
HOMEROOM T EACHER/COUNSELOR NAME:
STUDENT RACE: (PLEASE CIRCLE)
AMERICAN INDIAN OR ALASKAN NATIVE
ASIAN
BLACK OR AFRICAN AMERICAN
HISPANIC/LATINO
NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER
W HITE
TWO OR MORE RACES
PARENT NAME:
LAST
HAS THIS CHILD ATTENDED THE SATURDAY
SCHOOL BEFORE?
YES
NO
IF YES, FOR HOW MANY YEARS? ___________
PARENT’S CELL PHONE:
FIRST
MIDDLE INITIAL
PARENT’S WORK PHONE:
PARENT’S E-MAIL ADDRESS:
EMERGENCY CONTACT PHONE NUMBER (IF DIFFERENT ):
STREET ADDRESS: ______________________________
CITY: ________________________________
__________________________________________
STATE & ZIP: __________________________
Please notify the Center Director if you would like our staff to know about any learning needs,
medical conditions, food allergies, or 504 accommodations that are needed for your child.
AUTHORIZATION TO REQUEST / RELEASE PUPIL RECORDS AND PHOTOS
I HEREBY GIVE MY PERMISSION TO THE GEORGE B. THOMAS, SR. LEARNING ACADEMY TO REQUEST ACADEMIC RECORDS/ INFORMATION FOR THE
ABOVE STUDENT AND FOR MONTGOMERY COUNTY PUBLIC SCHOOLS (OR THE SCHOOL WHERE YOUR CHILD IS CURRENTLY ENROLLED) TO RELEASE
THOSE RECORDS. I ALSO GIVE MY PERMISSION FOR MY CHILD ’S PHOTO(S) TO BE USED IN LEARNING ACADEMY MARKETING MATERIALS.
_____________________________________________________________________
______________________
SIGNATURE OF PARENT/G UARDIAN
DATE
Is your family eligible for Free and Reduced-price Meals System (FARMS)?
YES
Do you need a payment plan to assist with registration fees?
YES
NO
Can you help pay the registration fee for a child who cannot afford it? YES
NO
NO
AMOUNT $_______
TOTAL PAID BY: CASH _____________ CHECK ________/__________ MONEY ORDER _________/_________
Amount
Check Number/Amount
MO Number/Amount