Schedule Change Request Form - ASI Cal Poly

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Schedule Change Request

ASI Children's Center

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Schedule changes are requested changes to your child’s schedule for the remainder of the quarter. One form per child, please.

After the second week of the quarter, there is a $25 fee that will be added to your bill for each schedule change.

Blank spaces indicate no time requested.

Name
First Last
Current Schedule*
Please list times for each day:
MON TUES WED THURS FRI
Requested Schedule*
Please list times for each day:
MON TUES WED THURS FRI
Date you would like this request to go into effect:*
Two days' notice required.
Reason for Request*
Signature*
Date*
MM slash DD slash YYYY
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Associated Students, Inc.
ASI Business Office University Union
1 Grand Avenue
San Luis Obispo, CA 93407