Wee Care Services Request
Please complete this form in its entirety to be placed on the waiting list for WeeCare Services. You will be notified by May 1 if your child will receive services for the upcoming school year.
Employee Name *
Your answer
Employee Email Address *
Your answer
LSSD Position *
Your answer
Location/School *
Child's Name *
Your answer
Child's Relationship to Employee *
Your answer
Child's DOB *
MM
/
DD
/
YYYY
Requested Start Date *
MM
/
DD
/
YYYY
Required
Submit
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