CCS Contact us

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Your Name
Address
Phone Numbers
Home:

Cell:
Other:
Email:
Date of birth
Grade 9    10     11     12 
      
  (If you are in 11-12th grade, are you interested in being a Peer Leader? Yes  No    Maybe)
       
Your Learning Community
     
Please list any school activities or hobbies that you like (for example: a sports team, creative writing, dance lessons, art, etc): 
     
Why are you interested in this program?
            
     

Are you available from 2:45-4:30 on Tuesdays and Thursdays?

Yes

No

Maybe 

 

Are you interested in having a mentor?

Yes

No

Maybe 

 

Are you interested in having a tutor? (homework help)

Yes

No

Maybe 
   
    
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Questions?

Call Maura 

(CAP Program Director) 

at 617-876-5214

 

Creative Action Project

A Program of 

Cambridge Community Services

99 Bishop Allen Drive

Cambridge, MA 02139

 
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