Verification Of Day Care Enrollment Form

ADVERTISEMENT

GWINNETT COUNTY PUBLIC SCHOOLS
VERIFICATION OF DAY CARE ENROLLMENT
School Year ______________
NOTE: This form is required for GCPS students being transported to a day care facility by GCPS.
Student:
________________________________________________________________________________________
School: ________________________________________________________________________________________________
(Child’s Full LEGAL Name)
Day Care Facility: ___________________________________________________________ Phone #: _______________
(GCPS School)
Day Care Address: ______________________________________ City: _____________ Zip Code: _______________
My child will be attending day care:
Monday Tuesday Wednesday Thursday Friday
(Circle days attending)
Starting on: ______________________ in the
AM only,
PM only or
AM & PM
(date)
Parent/Legal Guardian Signature
Date
Parent/Legal Guardian Printed Name
Relation to Child
DAYCARE USE ONLY:
The day care facility must provide the parent or fax to the school a copy of this day care verification
letter which must include the start date and day care director’s/designee’s signature.
Date
Day Care Facility Director/Designee Signature
Position
Day Care Facility Director/Designee Printed Name
My signature verifies that the above student information is correct and the student attends this day care facility.
Form: 3027-RF
Reviewed SY 11-12
Verification of DC Enrollment
Revised 07/11 dmc

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Education
Go