Change Notification ADD/CHANGE/CANCEL NotificationUse this form to initiate a change in your child's Extended Care.Please note that all monthly billing plans will be pro-rated to the nearest half-month.E-mail:Effective Date of ChangeFirst & Last Name(s) of all students affected by this Change NotificationPlease select ONE of the following options.Note that if you are changing from a regular monthly plan to A La Carte, please select "CHANGE" rather than "CANCEL".Checkbox:I would like to CANCEL enrollment in Before and/or After Care.I would like to CHANGE enrollment in Before and/or After Care.If you have selected CHANGE, please let us know which programs you are changing FROM and TO:Program(s) we WERE enrolled in:ProgramsA La Carte Before School CareA La Carte After School CareBefore School CareFULL-TIME After School CarePART-TIME After School CareProgram(s) we will NOW be enrolled in:Programs(1)A La Carte Before School CareA La Carte After School CareBefore School CareFULL-TIME After School CarePART-TIME After School CarePlease clarify or explain the changes you are requestingComments or special circumstancesPlease adjust the billing on my account to reflect the changes noted above. I understand that all monthly billing amounts will be pro-rated to the nearest HALF-MONTH.ES*Electronic Signature: Parent's permission is granted.SubmitReset