Which service does your child/young person attend?
*
Castleton Out of School Care
St Barts Out of School Care
Indi Youth
Child/young persons name:
*
First Name
Last Name
Parent/carers name:
*
First Name
Last Name
CURRENT DAYS: Please select the current days which you are already using our service:
*
Monday
Tuesday
Wednesday
Thursday
Friday
Holiday Cover Only
NEW REQUEST: Please indicate which days you now require.
*
Monday
Tuesday
Wednesday
Thursday
Friday
Please select the type of cover you require:
*
Annual
Term time
Holiday cover request (audits will be put out at holiday periods)
AM service
When would you like the change to take place?
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Parent/carer signature:
*
Submit
For internal use only
Request outcome
Your request has been granted
Date effective from
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Request outcome
We are unable to grant your request at this time, this has now been added to our waiting list and we will contact you as soon as this becomes available
Staff name
First Name
Last Name
Staff signature
Date
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Change of Days Form
Should be Empty: