BUSY BEE PRE-SCHOOL

S U M M E R   D A Y   C A R E 
Schedule Form

Dear Parents,
We know that many of you may or may not need day care services over the summer months.  It would be helpful in our planning if you could let us know your needs with this form.  We also ask that if you won't be needing day care, that you check the appropriate box below.  If your schedule will remain the same, please indicate below.

STUDENTS NAME______________________________________________________________ 

Please complete the following table with the day care schedule that you will require this summer.

STARTING DATE: ______/_____/______         ENDING DATE (if any) _____/_____/_____

____  Thank you, but we will not need day care services this summer. Our last day will be _______________.

Our summer schedule begins June 2, 2003.

___________________________________________________________   Date ___ / ___ / ___
Signed by parent or guardian