Full-Day/half-Day Schedule Request

Full-Day/Half-Day Schedule Request

Parent’s Name_________________________________________________________

Child’s Name: _________________________________________________________

Home Address: ________________________________________________________

_____________________________________________________________________

Telephone Number: _____________________________________________________

My child will be attending the:

______ Tuition-based full-day program from 8:35AM– 3:15PM.

______ Free half-day program from 8:35AM – 11:35PM

Parent signature

Date:

______ I believe that I may be eligible for a free or reduced tuition based on the income

information I am providing.

In order to verify your income information, please submit a copy of your 2015 income tax return

along with a copy of the two most recent paycheck stubs for all employed adults in your

household. If you receive “other” income, such as alimony, SSI/AFDC, or child support, we

need a copy of your recent checks to document this income. All documents should be submitted

to the school in a sealed envelope with your child’s name and “kindergarten tuition information”

clearly marked on the front. This information is required for all free and reduced tuitions. If this

documentation is not submitted, you will be required to pay the full tuition or to place your child

in the free half-day program.

Family Size

Total Gross Monthly Income

(include all members of

(income before taxes and other withdrawals)

the household)

Parent signature

Date:

The Hull Public School System Does Not Discriminate On The Basis of Age, Race, Color, National Origin, Gender, Disability, Religion, Gender Identity, Homelessness or Sexual Orientation.