Request for Daycare Stop 2022-2023

2022-2023 East Bridgewater Public Schools

Request for Daycare Stop

PLEASE COMPLETE A SEPARATE FORM FOR EACH CHILD

Please complete the form below. Required fields marked *

Request for Daycare Stop must be submitted by June 17, 2022. This includes students that are filling out Free & Reduced Meals paperwork; this paperwork must be filled out every year.

Contact Information

Student's First Name *

Answer Required

Student's Last Name *

Answer Required

Parent/Guardian First & Last Name*

Answer Required

Parent/Guardian Email *

Answer Required

Parent/Guardian Contact Telephone Number*

Answer Required

Address

Street Address

Answer Required

Payment Method*

Answer Required

I will be Filling Out Free & Reduced Meals Paperwork in July

I Paid on Unipay

We are in grade K-6 and live 2 or more miles away from the school.

Grade in 2022-2023 School Year*

Answer Required

Daycare Name*

Answer Required

Daycare Address*

Answer Required

Please fix the highlighted areas below before submitting.

Request for Daycare Stop 2022-2023