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Change Notification

ADD/CHANGE/CANCEL Notification

Use 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 Change
First & Last Name(s) of all students affected by this Change Notification

Please 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".

If you have selected CHANGE, please let us know which programs you are changing FROM and TO:

Program(s) we WERE enrolled in:


Program(s) we will NOW be enrolled in:

Please clarify or explain the changes you are requesting
Comments or special circumstances

Please 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.