* Required

Changes Needed - Extended Day Enrollment

Please use this form to make any changes or updates to your Extended Day registration. Your changes will be processed and you will be contacted if there are any questions or concerns. You will not be charged on this form, all changes in fees will be made by the business office and applied to your account.

Enrolled student's first namerequired

Enrolled student's last namerequired

What action would you like to take?required

Please explain:required

Please list the student(s) you would like to cancel Extended Day enrollment for:required

Please provide the NEW personal information only:required

Please indicate which pick-up contacts should be removed:required

Please indicate the new pick-up contact (name, phone, relationship):required

Please select the NEW Extended Day option you would like:required

Please send a confirmation email to the address below*: