CENTER HOLIDAY & SCHOOL CLOSURE FORM

Youth Educational Services, Inc. Child and Adult Care Food Program
CENTER HOLIDAY & SCHOOL CLOSURE FORM
Instructions: Complete this form if your Center is going to be closed for the day, a portion of the day or for a Holiday. Fill-in the appropriate information and hit "SUBMIT".
Center’s Name
Center’s Address
City
State
Zip
Person Completing this form
Phone number
Format: (000) 000-0000.
Please list the Dates, Time and Reason Center is Closed

HolidayReasonTimeHolidayCheck (1 of the 3 options) the reason for closure and complete items below.NotesHolidayDate/s of ClosurePhone numberHolidayZip_ Center’s Address:Weather/Emergency School Closing Other
Date/s of Closure
Time
Authorized Signature
Date

MonthDayYear
Date
Note: All Center Closing must be submitted into YES office at least 3 days prior to the closing.
YES Staff:
For Use by YES Inc. ONLY Date: Place original in Closure File and a copy in the Organization’s Permanent File

MonthDayYear
Date
For Use by YES Inc. ONLY Date: Place original in Closure File and a copy in the Organization’s Permanent File

MonthDayYear
Date
Should be Empty: