CFC-Service Change Request-Children's Centers

Service change requests for families with a child enrolled at the U-M Children's Centers (Health System, North Campus or Towsley).

Requestor Information

We'll contact you via your UMICH address. If you prefer we use a different address, please enter that here.

Request Information

Title
A short description to explain the nature of a ticket.
Children's Centers' Service Change Request
Request status
Request status
Child's Center
Child's Center
Child's Class
If your child is enrolled in the GSRP program, please select your child's class name with "enrolled in GSRP", for example "Geckos (enrolled in GSRP)." This will ensure all options relevant to GSRP enrollees populate in the form.
Child's Class
Desired Service or Change
Desired Service or Change
I understand that activating a login for the secondary account holder on my EZChildTrack account will provide them with full access to and the ability to make changes to my account. I further understand that removing their login is not complete until I have received a confirmation email.
I understand that activating a login for the secondary account holder on my EZChildTrack account will provide them with full access to and the ability to make changes to my account. I further understand that removing their login is not complete until I have received a confirmation email.
I would like to:
I would like to:
A $20 schedule change fee will be charged to your account upon approval of this request.
A $20 schedule change fee will be charged to your account upon approval of this request. (required)
Schedule changes and additional days are dependent on availability and not guaranteed. You will be notified if your request is available.
Schedule changes and additional days are dependent on availability and not guaranteed. You will be notified if your request is available. (required)
Six week's notice is required to reduce your schedule. Also, please note, partial week schedules are limited and may not be available.
Six week's notice is required to reduce your schedule. Also, please note, partial week schedules are limited and may not be available.
Current Schedule
Current Schedule (required)
Desired Schedule
Desired Schedule (required)
If approved, would you like extended care on the requested additional day?
If approved, would you like extended care on the requested additional day? (required)
If approved, would you like to purchase lunch on the requested additional day? (please note lunch orders must be placed by Tuesday 5 p.m. for the following week, so please choose 'yes', only if there is sufficient lead time)
If approved, would you like to purchase lunch on the requested additional day? (please note lunch orders must be placed by Tuesday 5 p.m. for the following week, so please choose 'yes', only if there is sufficient lead time)
Please choose the lunch for the appropriate day of the week you would like to purchase if your additional day request is approved. (please note: lunch orders must be placed by Tuesday 5 p.m. for the following week)
Please choose the lunch for the appropriate day of the week you would like to purchase if your additional day request is approved. (please note: lunch orders must be placed by Tuesday 5 p.m. for the following week)
If your schedule change is approved, what would you like to do with your lunch schedule?
If your schedule change is approved, what would you like to do with your lunch schedule?
If your schedule change is approved, will you need extended care?
If your schedule change is approved, will you need extended care? (required)
Additional Day Billing Acknowledgement
Additional Day Billing Acknowledgement (required)
To be eligible for a security deposit refund, this withdrawal notification must be received a minimum of six weeks prior to the child's last day of attendance and you must not have an outstanding balance due.
To be eligible for a security deposit refund, this withdrawal notification must be received a minimum of six weeks prior to the child's last day of attendance and you must not have an outstanding balance due. (required)
To be eligible for a security deposit refund, this cancelation of upcoming enrollment must be received a minimum of six weeks prior to your child's scheduled start date and you must not have an outstanding balance due.
To be eligible for a security deposit refund, this cancelation of upcoming enrollment must be received a minimum of six weeks prior to your child's scheduled start date and you must not have an outstanding balance due.
Extensions to your submitted withdrawal date may not be available, as the open space will be offered to families on the waitlist.
Extensions to your submitted withdrawal date may not be available, as the open space will be offered to families on the waitlist. (required)
Will your mailing address change soon?
Will your mailing address change soon?
Refunds are processed within approximately six weeks after child's last day of attendance or notification of canceled upcoming enrollment.
Refunds are processed within approximately six weeks after child's last day of attendance or notification of canceled upcoming enrollment.
Every effort will be made to process your refund after your last tuition payment has cleared and before you leave the U.S. Please keep us updated if your travel dates change.
Every effort will be made to process your refund after your last tuition payment has cleared and before you leave the U.S. Please keep us updated if your travel dates change.
If you are interested in future enrollment for this child, please complete a new waitlist application at https://hr.umich.edu/benefits-wellness/work-life/child-care-resources/childrens-centers/submit-childrens-center-waitlist-application.
If you are interested in future enrollment for this child, please complete a new waitlist application at https://hr.umich.edu/benefits-wellness/work-life/child-care-resources/childrens-centers/submit-childrens-center-waitlist-application.
Reason for withdrawal or cancelation. Please select all that apply.
Reason for withdrawal or cancelation. Please select all that apply.
What type of GSRP wrap around care request would you like to make?
What type of GSRP wrap around care request would you like to make?
Please note: Wrap around care availability is not guaranteed unless requested prior to the beginning of the GSRP year. You will be notified of availability.
Please note: Wrap around care availability is not guaranteed unless requested prior to the beginning of the GSRP year. You will be notified of availability.
What would you like your child's new wrap around schedule to be? (Please note to request care before 8 a.m. or after 5:30 p.m. complete this form again and choose "Extended Care Request")
What would you like your child's new wrap around schedule to be? (Please note to request care before 8 a.m. or after 5:30 p.m. complete this form again and choose "Extended Care Request")
Please note: Cancelation of wrap around care requires six weeks notice in order for us to adjust staffing and/or offer to families on the waitlist.
Please note: Cancelation of wrap around care requires six weeks notice in order for us to adjust staffing and/or offer to families on the waitlist.
What kind of extended care request would you like to make?
What kind of extended care request would you like to make?
Full Hour Early Care: Which days of the week would you like your child to attend early care beginning at 7:00 a.m.? (Please check those previously enrolled that you would like to continue and new days you'd like to add.)
Full Hour Early Care: Which days of the week would you like your child to attend early care beginning at 7:00 a.m.? (Please check those previously enrolled that you would like to continue and new days you'd like to add.) (required)
Half Hour Early Care: Which days of the week would you like to enroll in early care beginning at 7:30 a.m.? (please check those previously enrolled that you would like to continue and new days you'd like to add.)
Half Hour Early Care: Which days of the week would you like to enroll in early care beginning at 7:30 a.m.? (please check those previously enrolled that you would like to continue and new days you'd like to add.) (required)
Late Care: Which days of the week would you like to enroll in late care from 5:30-6:00 p.m.? (please check those previously enrolled that you would like to continue and new days you'd like to add.)
Late Care: Which days of the week would you like to enroll in late care from 5:30-6:00 p.m.? (please check those previously enrolled that you would like to continue and new days you'd like to add.) (required)
Additional extended care availability is not guaranteed. You will be notified if your requested schedule is available.
Additional extended care availability is not guaranteed. You will be notified if your requested schedule is available. (required)
What time(s) would you like to request extended care on the date listed above?
What time(s) would you like to request extended care on the date listed above? (required)
What type of lunch request would you like to make? (for pricing, please open the help text by clicking on the question mark)
Current lunch pricing:
ala carte (individual non-recurring days) @ $9.25/lunch

Recurring schedules:
5 days per week $36.25/week ($7.25/lunch; $8.75 minus $1.50 5-lunches/week discount)
4 days per week $31/week ($7.75/lunch; $8.75 minus $1.00 4-lunches/week discount)
3 days per week $24.75/week ($8.25/lunch; $8.75 minus $0.50 3-lunches/week discount)
2 days per week $17.50/week ($8.75/lunch)
1 day per week $8.75/week ($8.75/lunch)
What type of lunch request would you like to make? (for pricing, please open the help text by clicking on the question mark)
All lunch orders, changes and cancelations are due by Tuesday 5 p.m. in order to take effect the following week.
All lunch orders, changes and cancelations are due by Tuesday 5 p.m. in order to take effect the following week. (required)
Does your child have food allergies?
Does your child have food allergies?
Please check all that apply. For allergies not listed, please select "Other, please list below" and provide details in the box provided.
Please check all that apply. For allergies not listed, please select "Other, please list below" and provide details in the box provided. (required)
Does your child have any dietary preferences or food restrictions?
Does your child have any dietary preferences or food restrictions?
Please check all that apply. For dietary preferences or food restrictions not listed, please select "Other, please explain below" and provide details in the box provided.
Please check all that apply. For dietary preferences or food restrictions not listed, please select "Other, please explain below" and provide details in the box provided. (required)
Lunch fees will be added to your account upon approval and will be due on the last business day of this month.
Lunch fees will be added to your account upon approval and will be due on the last business day of this month. (required)
What would you like your child's new ongoing lunch schedule to be? (please include lunches you already purchase and want to continue and any new lunches you'd like to add)
What would you like your child's new ongoing lunch schedule to be? (please include lunches you already purchase and want to continue and any new lunches you'd like to add) (required)
Why did you change or cancel lunches?
Why did you change or cancel lunches?
Which lunches would you like to purchase during the week indicated above?
Which lunches would you like to purchase during the week indicated above? (required)
What type of Camp Go Blue extended care request would you like to make?
What type of Camp Go Blue extended care request would you like to make?
Extended care availability is not guaranteed. You will be notified if your requested schedule is available.
Extended care availability is not guaranteed. You will be notified if your requested schedule is available.
CGB Full Hour Early Care: For the week indicated above, which days would you like your child to attend extended care from 7:00-8:00 a.m. (please include days you previously requested and any new days you'd like to add).
CGB Full Hour Early Care: For the week indicated above, which days would you like your child to attend extended care from 7:00-8:00 a.m. (please include days you previously requested and any new days you'd like to add). (required)
CGB Half Hour Early Care: For the week indicated above, which days would you like your child to attend extended care from 7:30-8:00 a.m., but not 7:00-7:30 a.m. (please include days you previously requested and any new days you'd like to add).
CGB Half Hour Early Care: For the week indicated above, which days would you like your child to attend extended care from 7:30-8:00 a.m., but not 7:00-7:30 a.m. (please include days you previously requested and any new days you'd like to add). (required)
CGB Late Care: For the week indicated above, which days would you like your child to attend extended care from 5:30-6:00 p.m.? (please include days you previously requested and any new days you'd like to add).
CGB Late Care: For the week indicated above, which days would you like your child to attend extended care from 5:30-6:00 p.m.? (please include days you previously requested and any new days you'd like to add). (required)
Please note: Registration fees for each session are non-refundable. Tuition is due for all sessions in which you enroll unless we recieve four weeks notice of cancellation.
Please note: Registration fees for each session are non-refundable. Tuition is due for all sessions in which you enroll unless we recieve four weeks notice of cancellation. (required)
GSRP Summer Enrollment Choice
GSRP Summer Enrollment Choice
Which days of the week would you like to enroll your child for summer care?
Which days of the week would you like to enroll your child for summer care? (required)
What are your extended care needs (i.e. care prior to 8 a.m. and/or after 5:30 p.m.)?
What are your extended care needs (i.e. care prior to 8 a.m. and/or after 5:30 p.m.)?
To make a change to my child's extended care schedule (i.e. care prior to 8 a.m. and/or after 5:30 p.m.) I understand I need to submit the service change form again and choose "Extended Care Request (7:00-8:00 a.m., 5:30-6:00 p.m.)."
To make a change to my child's extended care schedule (i.e. care prior to 8 a.m. and/or after 5:30 p.m.) I understand I need to submit the service change form again and choose "Extended Care Request (7:00-8:00 a.m., 5:30-6:00 p.m.)."
I understand that if I do not register by February 15, summer space for my child is not guaranteed.
I understand that if I do not register by February 15, summer space for my child is not guaranteed.
Summer care tuition is non-refundable after due dates: Tuition for care 6/8-7/2 is due 3/31, for 7/6-7/31 is due 4/30 and for 8/3-8/21 is due 5/29.
Summer care tuition is non-refundable after due dates: Tuition for care 6/8-7/2 is due 3/31, for 7/6-7/31 is due 4/30 and for 8/3-8/21 is due 5/29.
File attachments associated with the ticket.
Browse...

Other Fields

Your name
Verification Code