103 Club Permanent Schedule Change Form
Please use this form to make permanent 103 Club schedule changes.  In addition to filling out this form, please send a note to your child's classroom teacher on the first day of the schedule change.
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Email *
Child's Name *
Child's grade *
Current Schedule *
Starting date of schedule change- (two week notice required) *
MM
/
DD
/
YYYY
New Schedule (check all that apply, minimum 2 days)
Monday
Tuesday
Wednesday
Thursday
Friday
No longer attending
AM
PM
Comments:
A copy of your responses will be emailed to the address you provided.
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