ECLC "Change of Enrollment" Form 2022-23

ECLC "Change of Enrollment" Form (School Year 2022-2023)
Child's Name*

First NameLast Name
Paren't Name*

First NameLast Name
Program Currently Enrolled*

Noah's Ark - 8 weeks old by by 9/1/22Toddlers - 12 months by 9/1/22Twos - 2 years by 9/1/22Threes - 3 years by 9/1/22Pre-K/VPK - 4 years by 9/1/22VPK Virtual Flex ProgramKindergarten - 5 years by 9/1/22
Classroom Currently Enrolled*
New Program*

Noah's Ark - 8 weeks old by by 9/1/22Toddlers - 12 months by 9/1/22Twos - 2 years by 9/1/22Threes - 3 years by 9/1/22Pre-K/VPK - 4 years by 9/1/22VPK Virtual Flex ProgramKindergarten - 5 years by 9/1/22
Program Hours (Noah's Ark)*

5 days (Mon-Fri), 7am-6:00pm3 days (M/W/F), 7am-6:00pm2 days (Tu/Th), 7am-6:00pm
Program Hours (Toddlers & Twos)*

5 days (Mon-Fri), 9am-12:30pm5 days (Mon-Fri), 9am-3pm5 days (Mon-Fri), 7am-6:00pm3 days (M/W/F), 9am-3pm3 days (M/W/F), 7am-6:00pm2 days (Tu/Th), 9am-3pm2 days (Tu/Th), 7am-6:00pm
Program Hours (Threes)*

5 days (Mon-Fri), 9am-3pm5 days (Mon-Fri), 7am-6:00pm3 days (M/W/F), 9am-3pm3 days (M/W/F), 7am-6:00pm2 days (Tu/Th), 9am-3pm2 days (Tu/Th), 7am-6:00pm
Program Hours (Pre-K)*

5 days (Mon-Fri), 9am-3pm5 days (Mon-Fri), 7am-6:00pm5 days (Mon-Fri), 9am-12pm (VPK only)5 days (Mon-Fri), 12pm-3pm (VPK only)
Program Hours (Kindergarten)*

5 days (Mon-Fri), 9am-3pm5 days (Mon-Fri), 7am-6:00pm
Date Program Change Effective:*

MonthDayYear
Date
Is this a permanent or temporary program change?*

PermanentTemporary
Temporary Date Ending*

MonthDayYear
Date
Parent's Signature*
Today's Date

MonthDayYear
Should be Empty:

ECLC "Change of Enrollment" Form (School Year 2022-2023)