Extended Day Schedule Change Form
ALL COMMUNITY EDUCATION SCHEDULE CHANGES NEED TO BE SUBMITTED BEFORE THE 10TH OF THE MONTH. THIS SCHEDULE CHANGE WILL BE EFFECTIVE THE FOLLOWING MONTH.
Child's Name: *
Your answer
Grade: *
Required
Parents/Guardians Name *
Your answer
Parents/Guardians Email *
Your answer
Parents/Guardians Telephone Number (please indicate home, cell or work number) *
Your answer
Date of Notice: *
MM
/
DD
/
YYYY
Extended Day Program - Location *
School your child attends *
Current Schedule
Monday
Tuesday
Wednesday
Thursday
Friday
AM
PM
AM/PM
New Schedule
Monday
Tuesday
Wednesday
Thursday
Friday
AM
PM
AM/PM
Submit
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