Extended School Day Intervention Request

Please complete this form to RSVP for the RRMS Extended School Day Intervention Programs. This program operates M-R 2:30PM-4:30PM and Saturdays from 8AM-11AM at River Ridge Middle School for students who need Reading/ELA and/or Math intervention services. Please contact Assistant Principal, Kevin Kolean for more information.

Student's Name Student's Name First Last
Student ID Number
Student's Grade Level
Parent/Guardian's Name Parent/Guardian's Name First Last
Parent/Guardian's Email Address
I would like my child to be considered for participation in the Extended School Day Program at RRMS. I understand that she/he would need to attend consistently and follow classroom rules. I also understand that I will be contacted when and if the program is available.

I would like my child to be considered for participation in the Extended School Day Program at RRMS. I understand that she/he would need to attend consistently and follow classroom rules. I also understand that I will be contacted when and if the program is available. Please check here if you would like your child to participate.
Transportation Requested

Transportation Requested None School Bus Transportation
I would prefer that my child NOT be considered for the Extended School Day Program at RRMS at this time.

I would prefer that my child NOT be considered for the Extended School Day Program at RRMS at this time. Please check here if your child WILL NOT be participating at this time.
Parent Signature

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.