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Community Day Charter Public School
K1-8 Charter Public School in Lawrence, MA

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Available Programs
Early Learning
Education and care program for children from infancy to school age

Community Kids Place
Out-of-school time enrichment program for school aged children

Training and Workforce Development
Provides coaching, support, and professional development

Child Care Circuit
Provides child care referrals and resources throughout the Commonwealth, along with provider services both locally and nationwide

Community Day Charter Public School
K1-8 Charter Public School in Lawrence, MA
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Financial Assistance Request

Financial Assistance Requestthecommunitygr2024-12-10T09:25:44-05:00

CHANGES TO CHILD CARE FINANCIAL ASSISTANCE REQUEST FORM

Parent Name

Contact Phone Number

Contact Email Address

Enter Email Confirm Email

City or Town of Residence

Name of the Program or Provider Your Child Currently Attends

Changes

New Address

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Untitled

Telephone Number. My new number is:

Phone

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Add transportation to the child care financial assistance*

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One Way

Two Way

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Delete transportation from the child care financial assistance

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Change in child care provider

New Program

Reason for this provider change?

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Add a child to my family size - (must submit birth certificate)

Child Name

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Change in parent fee: I'm submitting new pay stubs (4 if you get paid weekly, 2 if biweekly)

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Change in full-time care. I'm submitting new pay stubs to support my service need. (4 pay stubs if you get paid weekly; 2 if biweekly)

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Change in part-time care

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Other

Other Details

Change Effective Date (mm/dd/yyyy)

MM slash DD slash YYYY

* Please Note: If the change(s) you requested requires a signature, your case manager will be in contact with you.

Child Care Circuit | 190 Hampshire Street, Lawrence, MA 01840 | 978-686-4288

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