9. RATES: Enter the advertised rates (private pay rates) your program charges in the table below. Do not include voucher/subsidy rates, sliding scale rates, employee discounts or any other discounted rates. Only complete the rate type for each age group that you offer. (Please attach rate sheet, if applicable). *REQUIRED Elem Enter Rate by Age Group. 1 year 2 year 3 year 4 year 5 year Mid School Infant School Check frequency for each option below. old old old old old Age Age FULL TIME Weekly Monthly Annually FULL TIME VPK WRAP Weekly Monthly Annually PART TIME Weekly Monthly Annually PART TIME VPK WRAP Weekly Monthly Annually SCHOOL AGE BEFORE SCHOOL Weekly Monthly Annually SCHOOL AGE AFTER SCHOOL Weekly Monthly Annually SCHOOL AGE BOTH BEFORE & AFTER – SCHOOL Weekly Monthly Annually SUMMER CAMP Weekly Monthly Annually 10. SCHEDULE - What days of the week does your program operate? Describe your program schedule. (Check all that apply) *REQUIRED Sunday Monday Tuesday Wednesday Thursday Friday Saturday Hours of Operation: Open: Close: AM PM AM PM Ages of Children Served: Minimum: (Months/Years) (Months/Years) 24-Hour Care Full Time School Syst Weather Days After School Full Year School Year Before School Overnight sWING SHIFT Drop In Care Part Time Weekend Emergency/Temporary Care Respite Care Evening Care Summer Only What other services does your program offer? 11. ENHANCED SERVICES - (Check all that apply) *REQUIRED Art/Crafts Music Lessons environ accommodations Computers Kindergarten Class Training/exp dev delay Dance On-site Screenings Therapeutic Services Family involvement Outdoor Sports OTHER (List Below) Field Trips Swim Lessons Gymnastics Training/exp autism Homework/Tutor Training/exp behav chal
9. RATES: Enter the advertised rates (private pay rates) your program charges in the table below. Do not include voucher/subsidy rates, sliding scale rates, employee discounts or any other discounted rates. Only complete the rate type for each age group that you offer. (Please attach rate sheet, if applicable). *REQUIRED Enter Rate by Age Group. Check frequency for each option below. Infant 1 year old 2 year old 3 year old 4 year old 5 year old Elem School Age Mid School Age FULL TIME Weekly Monthly Annually FULL TIME VPK WRAP Weekly Monthly Annually PART TIME Weekly Monthly Annually PART TIME VPK WRAP Weekly Monthly Annually SCHOOL AGE BEFORE SCHOOL Weekly Monthly Annually SCHOOL AGE AFTER SCHOOL Weekly Monthly Annually SCHOOL AGE – BOTH BEFORE & AFTER SCHOOL Weekly Monthly Annually SUMMER CAMP Weekly Monthly Annually 10. SCHEDULE - What days of the week does your program operate? Describe your program schedule. (Check all that apply) *REQUIRED Sunday Monday Tuesday Wednesday Thursday Friday Saturday Hours of Operation: Open: AM PM Close: AM PM Ages of Children Served: Minimum: (Months/Years) (Months/Years) 24-Hour Care Full Time School Syst Weather Days After School Full Year School Year Before School Overnight sWING SHIFT Drop In Care Part Time Weekend Emergency/Temporary Care Respite Care Evening Care Summer Only 11. ENHANCED SERVICES - What other services does your program offer? (Check all that apply) *REQUIRED Art/Crafts Music Lessons environ accommodations Computers Kindergarten Class Training/exp dev delay Dance On-site Screenings Therapeutic Services Family involvement Outdoor Sports OTHER (List Below) Field Trips Swim Lessons Gymnastics Training/exp autism Homework/Tutor Training/exp behav chal
Provider%20Update%20Form%202016-2017.docx