Before school cc permanent schedule change

Email*

Person Filling in Form*

First Last

Relation to Child*

Mom
Dad
Legal Guardian

Child*

First Last

What school does your child attend?*

Otsego
Paumanok
Signal Hill
Sunquam
Vanderbilt

Date Schedule Change Becomes Effective

*Prior to first day of school permanent schedule changes must be submitted two weeks in advance. During the school year permanent schedule changes must be made one week in advance.

Permanent Schedule Change*

Add Day(s) Permanently to Schedule (subject to availability)
Delete Day(s) Permanently from Schedule
Add "Emergency Use" for Before School Child Care
Changing Schedule from Consistent to Emergency Use
I would like to entirely WITHDRAW from Child Care Program

Day(s) of Schedule Change (choose all that apply)*

Monday
Tuesday
Wednesday
Thursday
Friday

BEFORE SCHOOL CHILD CARE PERMANENT SCHEDULE CHANGE FORM

BEFORE SCHOOL CHILD CARE PERMANENT SCHEDULE CHANGE FORM