ELD STATUS CHANGE/WITHDRAW FORM
You must make your status change request before the 25th of the month to allow the change to occur on the following month. We will not accept request after the 25th of each month.

Cambios deben ser pedidos antes del 25 del mes para poder hacer los cambios para el mes que sigue. Cambios después del 25 no serán aceptados.

Child's Name | Nombre del alumno *
Your answer
Parent's Name | Nombre del padre/madre *
Your answer
Facility *
Current Schedule | Horario actual *
New Schedule | Nuevo horario *
Part Time Schedule | Horario de tiempo medio
Temporary Withdraw | Retiro temporario
Today's Date | Fecha de hoy *
MM
/
DD
/
YYYY
New Schedule/Withdraw Start Date | Fecha para retiro o nuevo horario *
MM
/
DD
/
YYYY
We understand that your need for childcare may change during the school year. We are happy to accommodate schedule changes when we can.

In order for you to end your ELD contract or for your child to withdraw from the program, you must request the change prior to the requested month. Parents are still responsible for any remaining tuition payments during that month or for any missed payments.

Requests for schedule changes are accepted throughout the school year. Please consider your request carefully. This form initiates the formal process by the parent (s). Only the parent who enrolled the child can request a change/withdrawal from the ELD Program.

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