Middle School Program Application

The Middle School Program serves first-generation* and low-income** students from the greater Newark area.   

If you are interested in NJ LEEP’s 2019 Summer Middle School Program, please complete the application below. Students must currently be in the 5th grade to apply.

The program is a five-week summer course that introduces students to the NJ LEEP culture, excites them about learning, and begins the skill-building process.  After completing the program, scholars will be able to participate in NJ LEEP’s school-year Middle School Program.

*We define first-generation college students as those who are the first in their family to go to college and earn a four-year college degree in the United States.
**We define low-income as an income of $70,000 or below for a family of four (for each additional household member, we add $5,000 to the threshold).

For additional information on how to apply, contact Catherine Ventura, Enrollment and Data Manager, at 973-297-1555, ext. 201 or cventura@njleep.org.

Student Information
Student Name *
Student Name
Student Gender *
Student Date of Birth *
Student Date of Birth
Student Phone Number
Student Phone Number
Home Address *
Home Address
Parent/Guardian 1 Information
Parent 1 Name *
Parent 1 Name
Resides with Student? *
Parent 1 Phone Number *
Parent 1 Phone Number
Did you or another parent receive a degree from a 4-year college in the U.S.? *
Parent/Guardian 2 Information
Parent 2 Name
Parent 2 Name
Resides with Student?
Parent 2 Phone Number
Parent 2 Phone Number
Additional Information
Does student have a sibling in NJ LEEP?
Does student receive free/reduced lunch? *
Will student need to be provided lunch during summer program? *
Will student be participating in both summer and academic program?
Academic program will be 16 Saturdays throughout the school year.
How will student arrive to/depart from program?
*Submit a copy of household financial document (1040 or Parents' W2s) and student's most recent report card.
Required documents can be emailed to: cventura@njleep.org. Application is incomplete until documents are received.