Christine Syriac Superintendent of Schools csyriac@seymourschools.

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APPLICATION
CITIZENS ACADEMY Fall, 2013

The Seymour Public School District invites you to learn more about our public schools by participating in our Citizens Academy. We plan to provide an enjoyable experience that we hope will help foster improved communication and cooperation between the school district and the citizens of Seymour. The Citizens Academy will meet five times; four sessions are in the evening from 6:00 p.m. to 8:30 p.m. (dinner provided) and one tour of the schools from 9:30 a.m. to 1:30 p.m. See the attached flyer for dates, topics, times, and locations. Please complete the application below and return by September 4, 2013: Lee-Ann Dauerty Seymour Public Schools 98 Bank Street Seymour, CT 06483 It can also be emailed to: ldauerty@seymourschools.org. You will be contacted if you are in the next session or placed on a waiting list. If you have questions, please call 203.888.4564 x1904
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Full Name Mailing Address Home Phone Business Phone email address

[ ] Male [ ] Female

Cell Phone

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98 Bank Street Seymour, CT 06483 Tel 203.888.4564 Fax 203.888.1704 www.seymourschools.org
Seymour Public Schools is committed to a policy of equal opportunity/affirmative action for all qualified persons and does not discriminate in any employment practice, education program, or educational activity on the basis of race, color, national origin, sex, sexual orientation, disability, age, religion or any other basis prohibited by Connecticut state and/or federal nondiscrimination laws. Inquiries regarding the nondiscrimination policies should be directed to the Title IX Coordinator, Nancy Snopkowski, Associate Superintendent, 203-888-4564.

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What is your connection to the Seymour Public Schools?

2.

How many years have you been a resident of Seymour?

3. 4. 5.

Children currently enrolled in schools Grandchildren in schools: Yes

Yes No

No

What is a question you have about The Seymour Public Schools that you hope will be addressed through the academy?