Schedule Change Request

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Schedule changes are subject to availability and must be made one month prior to the new schedule start date.

Email *

Student Name *

Today's Date *

YYYY

New Schedule Start Date *

YYYY

My child's current classroom is as follows: *

2-4 Pinon Pine

3-5 Juniper

3-6 Desert Willow

Required

My child's current schedule is as follows: Check all that apply. *

5 half days 9:00am-12:00pm (2-4 program)

5 full days 9:00am-3:00pm (2-4 program)

5 full days 9:00am-3:00pm (3-6 programs)

3 days of before care 7:30am-8:45am

4 days of before care

5 days of before care

3 days of aftercare 3:15pm-6:00pm

4 days of aftercare

5 days of aftercare

5 days of before and aftercare

Required

I would like to change my child's schedule to the following. Check all that apply. *

5 half days 9:00am-12:00pm (2-4 program)

5 full days 9:00am-3:00pm (2-4 program)

5 full days 9:00am-3:00pm (3-6 program)

3 days of before care 7:30am-8:45am

4 days of before care

5 days of before care

3 days of aftercare 3:15pm-6:00pm

4 days of aftercare

5 days of aftercare

5 days of before and aftercare

Required

Please Electronically sign and date. *

For Office Use:

Approved

Denied

Reason for Denial:

Submit

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