Change of Schedule
Student Name
Full-Day___ Extended Day___ Half-Day___ Half-Day Lunch Bunch___
7:00-6:30 9:00-2:30 9:00-12:00 9:00-12:00/nap
I am requesting a change in my child’s regular schedule for the following reason:
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Schedule Requested
Full-Day___ Extended Day___ Half-Day___ Half-Day Lunch Bunch___
7:00-6:30 9:00-2:30 9:00-12:00 9:00-12:00/nap
Other______________________________________
Permanent ___ Temporary___
If temporary, please list dates of change: From_________________ To_____________________
Please understand that we will try to accommodate needs in regards to schedule changes.
All changes are subject to the Director’s approval.
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Parent Signature