Schedule Change Request

It is important to make sure the after care staff is aware of schedule changes, first, for the safety of your children (to make sure everyone is accounted for on a given day) and second, to ensure accurate billing.

Name of child: _______________

Grade: ____________

School:____________

I would like to change my child’s before care schedule.

He/she will now attend on:

M T W Th F As Needed Basis Only

(Please circle day(s) OR “As Needed.” Please do not circle both. If your child is registered, he/she may attend before care on an “as needed” basis on any day that is not his/her scheduled day.)

I would like this change to be effective on the

� 15^th of ________ (month) � 30^th of _________(month)

_____________________________________________________________

I would like to change my child’s After Care schedule.

He/she will now attend on:

M T W Th F As Needed Basis Only

(Please circle day(s) OR “As Needed.” Please do not circle both. If your child is registered, he/she may attend after care on an “as needed” basis on any day that is not his/her scheduled day. Please remember to call 973.429.1269 the day you plan to send your child on an as needed basis. There is limited “As Needed” space in the 11-3 Pre-K program.)

I would like this change to be effective on the

� 15^th of ________ (month) � 30^th of _________(month)

Signature______________________ Date____________________________

Please return completed form to 235 Ridgewood Avenue.