Request for Additional or Extended Care
If you would like your child to stay late on an occasional basis, please fill out this form for our records. We ask that when possible, make your request the day PRIOR to when your child will be staying late. Mid-Mitten Montessori reserves the right to refuse any requests for additional programming time. Fees for staying late are listed below, and will be added onto your tuition statement for the following month. Completion of this form supports us in the planning accounting process.

  • Adding afternoon programing up to 3:45 - $20.00

  • Adding aftercare - $5.00

  • Adding both afternoon programming and aftercare: $25.00

  • Late requests (same day) will be charged an additional $2.50

Sign in to Google to save your progress. Learn more
Email *
Student Name(s) *
Current Program *
Date requesting additional care *
MM
/
DD
/
YYYY
Desired pick up time *
Time
:
Please indicate the total amount that should be added to your account:  *
Adding afternoon programing up to 3:45pm - $20.00
Adding aftercare - $5.00
Adding both afternoon programming and aftercare: $25.00
Late requests (same day) will be charged an additional $2.50
Please leave any comments about your request here: 
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Mid Mitten Montessori. Report Abuse
Google Forms