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Thank you for your interest in PYN's afterschool programs - please follow the instructions below to enroll in a program. 

How to Apply:

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Step 1: Click below to visit our application system, PYNDEX. 

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Step 2: Create a New Application.

Step 3: Confirm Email Address + Compete Your Application  

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HOLD FOR SCREENSHOT

Note: A separate application is needed for each youth being registered, and each application needs a separate email address. A school-issued email can be used for this purpose.

 

If you are registering multiple participants and do not have a separate email to use for each, reach out to us at afterschool@pyninc.org and we will provide assistance.

Step 4: Complete + Sign Additional Consent Statements:

CONSENT TO RELEASE EDUCATION RECORDS UNDER FERPA

 

The Out-of-School programs improves the well-being of children and youth through effective academic support, enrichment, and youth development activities during non-school hours. OST programming provides safe, constructive activities to children when they are not in school and has been demonstrated to improve in school performance.

 

In order to assess and improve the quality of OST programs, our third-party evaluators, Research for Action (RFA) asks for permission to collect personally identifiable information from education records regarding children’s school performance. They will collect standardized test scores, report cards and school attendance, disciplinary and other relevant school records (“education records”). RFA will use these education records to measure the impact of OST programming on children’s school performance and to improve the quality of those programs.

 

I am the parent or guardian of the student named above (“Student”). As authorized by applicable law, including but not limited to the Family Education Rights and Privacy Act, 20 U.S.C. 1232g, and 34 C.F.R. Part 99 (“FERPA”), I consent and authorize The School District of Philadelphia (the “School District”) to release education records concerning the Student, including confidential records of the School District, to the City’s Department of Human Services, the Public Health Management Corporation, and my Student’s OST program (“Recipients”).

 

The School District releases these education records in connection with the student’s participation in an OST program. The School District may disclose these education records only to the Recipients, and the Recipients may share this information only with other named Recipients, and with the Recipients’ officers, staff, administrators and independent contractors under the Recipients’ control.

 

The Recipients may use these education records to research, study or evaluate OST programs. If I ask, the School District will provide me with a copy of the records disclosed. FERPA and other applicable laws protect the confidentiality of and your right to privacy concerning the Student’s education records. The Recipients shall keep all information concerning the Student confidential and private to the fullest extent provided by applicable laws, including FERPA. Neither The School District nor the Recipients require me to waive any rights under these laws, and I give my consent voluntarily.

Consent to Collection and Use of Child’s Information:


Purpose:

  • PYN's 21st Century CCL OST & School District of Philadelphia (SDP) after school programs, hereafter referred to as "PYN's CCL OST Programs", track certain data and records in order to better serve participants.

  • When you enroll your child in an after-school program, a third-party evaluator may collect information from you and your child and from OST programs and the School District of Philadelphia and store it in a secure centralized system.

  • This information may be aggregated and used for reporting purposes for the program & the Department of Education.


Process:

  • When you sign up for an afterschool program, you will be asked to provide information about your child, including but not limited to his or her name, age, address, and other demographic information.

  • OST program staff may also visit the program and talk to your child about being at that program and may also ask your child to complete short surveys about the program to learn more about the experience; these visits are a part of afterschool programs for every child and every afterschool site.

  • Additional information may be added to your child’s file, including from the School District (if you agree) and other OST programs your child has attended including but not limited to: date of birth, gender, race, ethnicity, phone, ID, school name, grade, and attendance.


Information Privacy and Sharing of Information:

  • The information that is collected about your child will be shared with staff at the after-school program.

  • In addition, the information about your child will be shared with approved City and OST program and administrative staff, including providers or independent contractors.

  • If the City ever allows the information to be used for research or evaluation purposes, no identifying information about your child or your family will be shared.

  • All of the information will be stored in a database that complies with requirements for managing student education records as set forth in the Family Educational Rights and Privacy Act (FERPA).

  • Furthermore, the system is guarded by layered security protocols that prevents unauthorized persons from accessing the system. You also have the right to inspect and review documents collected and maintained in that system.

Permission for the Philadelphia Youth Network's (PYN) CCL Out of School Time (OST) programs to collect, store, and share the information I provide on my child for use in the OST program as outlined above and for my child and/or me to complete programmatic surveys that may be shared with other OST programs.

Permission for the Philadelphia Youth Network's (PYN) CCL OST programs to provide the School District of Philadelphia with information about my child’s attendance in the OST program for the purposes of programming for my child and overall program evaluation.

Permission for the School District of Philadelphia to release my child’s educational reports to the OST programs that have need for it. The information to be released under this consent is: all records; grades, test scores; AIMS scores; attendance; Individualized Education Programs if applicable; and any other measurements of academic performance racking programmatic progress. The information will be released for the following purposes: programming for my child and overall program evaluation

Permission for the Philadelphia Youth Network's (PYN) CCL OST programs to photograph, digitally record, videotape, or audio tape my child while s/he is participating in any PYN OST program. I further agree that any material may be used in publications, promotional literature, or in other similar ways, and that such use shall be without payment of fees. I understand that any photographs, videotapes, or audio tapes shall remain the property of PYN and that I do not have the right to prior approval of their use. I release and hold harmless the City of Philadelphia, PYN's OST programs, OST providers and their officers, employees, and agents from all claims and causes of action that I or my child may have as a result of the use of my child’s photograph, videotape, or audio tape in connection with the program.

ACKNOWLEGEMENT AND SIGNATURE:


By signing below, I acknowledge that I have read and understand this OST Data Sharing Consent Form and agreement to have my child’s information shared as described above.

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I understand that I may revoke this consent upon providing written notice to the OST program that my child attends. I further understand that until this revocation is made, this consent shall remain in effect and my educational records will continue to be provided to the OST program for the reasons described above.

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