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SMSD Change in Programming Request

  1. JCPRD Logo-3x3
  2. To request a change in your current programming option (currently Full Time, Before&After School Care) or to drop from the program, please complete this form.
  3. Request*

    *After October 19, one week advanced notice required and a $15.00 change fee will be assessed to your account per change.

  4. When would you like these changes to take effect? (Fees paid run through Fridays. New programming requests can start on Mondays.)
  5. Please list your programming change details here. For example, if you are currently enrolled in Before School Programming only and would like to add After School Programming as well, list that here.
  6. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. 4.) You agree to pay the $15.00 change fee if this request is made after October 19th, 2020.
  7. Leave This Blank:

  8. This field is not part of the form submission.