Afterschool Application

Sus Yaz Early Learning Center is pleased to offer Afterschool Care for families in our community. The school district transportation department has shared that children will be transferred from their public elementary school to the Sus Yaz Program each day on the bus (unless you specify otherwise), that your child is registered for. We will offer all day care for Non-Instructional Days, Early Dismissal Days, Spring and Summer Breaks. **Christmas Break schedule will be included in September newsletter each year. If your child attends NCC School, please speak with the school regarding transportation.

Child's Information

First Name:

Middle Name:

Last Name:

Birth Date:

Parent's Information

First Name:

Last Name:

Phone Number:

Mobile Number:

Please enter at least one phone number.

Email Address:

Child's School:

Grade in September: (2023-2024)

Effective Date of enrollment:

Program Information

Please check the Afterschool Program enrollment option desired for your child:

1 day per week
2 days per week
3 days per week
4 days per week
5 days per week

Indicate the days you anticipate utilizing the Afterschool Program:

Monday
Tuesday
Wednesday
Thursday
Friday

Pickup Time:

Will you be utilizing the program on all school closure days?

Yes
No

Will you be utilizing the program during the months of July & August?

Yes
No

Allergy Information

Does your child have any known allergies?

Yes
No

If yes please explain below:

Submit Application

Submitted On:

 

 

Submit Application