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CFC-Service Change Request-Children's Centers
CFC-Service Change Request-Children's Centers
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Service change requests for families with a child enrolled at the U-M Children's Centers (Health System, North Campus or Towsley).
Requestor Information
Preferred Email (if not your UMICH email)
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
Child_First Name
Child_Last Name
Child's Center
Child's Center
Health System Children's Center (HSCC) 2601 Glazier Way
North Campus Children's Center (NCCC) 2800 Plymouth Rd. in NCRC
Towsley Children's House (TCH) 710 S. Forest Ave.
Child's Class
Child's Class
Bunnies
Koalas
Frogs
Chicks
Penguins
Bears
Llamas
Geckos
Tigers
Red Tailed Hawks (HSCC)
Camp Go Blue
I'm not sure (HSCC)
Monarchs A or B
Fairy Bells
Painted Turtles
Spring Peepers
Apple Blossoms
Sweet Cherries
Sleeping Bears
Red Tailed Hawks (NCCC)
Petoskey Stones
North Stars
I'm not sure (NCCC)
Seedlings
Sprouts
Sassafras
Birch
Magnolia
Willow
Evergreen
Maple
Oak
Sycamore
I'm not sure (TCH)
Desired Service or Change
Desired Service or Change
HSCC Schedule Change (8:00 a.m.-5:30 p.m.)
NCCC Schedule Change
TCH Schedule Change
HSCC Additional Day Request
NCCC Additional Day Request
TCH Additional Day Request
Withdrawal Notification
Cancel Upcoming Enrollment
Extended Care Request (7:00-8:00 a.m., 5:30-6:00 p.m.)
Lunch Request
Camp Go Blue Extended Care: Add, Change or Cancel
Camp Go Blue Cancel Scheduled Session/week
Miscellaneous Question
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.
I understand.
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.
I understand
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.
I understand.
Current Schedule
Current Schedule
Monday
Tuesday
Wednesday
Thursday
Friday
Desired Schedule
Desired Schedule
Monday
Tuesday
Wednesday
Thursday
Friday
Requested date to begin desired schedule
(mm/dd/yyyy)
For what date are you requesting care?
(mm/dd/yyyy)
If approved, would you like extended care on the requested additional day?
If approved, would you like extended care on the requested additional day?
No, 8:00-5:30 only
Yes, 7:00-8:00 a.m. (full hour)
Yes, 7:30-8:00 a.m. (half hour)
Yes, 5:30-6:00 p.m. (half hour)
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)
Yes
No
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)
Monday- Turkey Pepperoni Pizza Lunch
Monday- Cheese Pizza Lunch
Tuesday- Chicken Taco Lunch
Tuesday- Black Bean Taco Lunch
Wednesday- Veggie Patty Paremsan Lunch
Thursday- Chicken Fried Rice Lunch
Thursday- Tofu Fried Rice Lunch
Friday- Mac & Cheese Lunch
Friday- Pasta Marinara w/Chickpeas Lunch
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?
Not applicable (i.e. we do not purchase school lunches)
No changes needed to my child's lunch schedule
If schedule change is approved, I will submit another form to request lunch changes
If your schedule change is approved, will you need extended care?
If your schedule change is approved, will you need extended care?
No extended care needed
Yes, 7:00 a.m.-8:00 a.m. (full hour) on all days of new schedule
Yes, 7:30 a.m.-8:00 a.m. (half hour) on all days of the new schedule
Yes, 5:30 p.m.-6:30 p.m. (half hour) on all days of new schedule
Yes, for some days of the new schedule
Additional Day Billing Acknowledgement
Additional Day Billing Acknowledgement
Tuition for additional days is billed upon approval and due at the end of the month.
Child's last day of attendance
(mm/dd/yyyy)
What was your child's scheduled start date?
(mm/dd/yyyy)
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.
I understand
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.
I understand
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.
I understand
Please provide your current mailing address (to be used for mailing a refund check, if you are owed a security deposit or tuition refund))
Will your mailing address change soon?
Will your mailing address change soon?
I am not moving. Any necessary refund can be mailed to the address above.
I am moving within the U.S.
I am moving outside the U.S.
What is the last day you can receive mail at your current address?
(mm/dd/yyyy)
Forwarding Address (in the U.S.)
What is the first day you can receive mail at your forwarding address?
(mm/dd/yyyy)
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.
I understand
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.
I understand
Would you like your child to be placed back on the waitlist for possible future enrollment?
Would you like your child to be placed back on the waitlist for possible future enrollment?
Yes
No
What is your desired future enrollment date?
(mm/dd/yyyy)
Reason for withdrawal or cancelation. Please select all that apply.
Reason for withdrawal or cancelation. Please select all that apply.
Child aged out of the program.
We are moving out of the area.
We no longer need child care.
Child was offered enrollment in a public PreK, Young 5 or similar class.
We found other local care that better meets our needs. Please explain below.
The program did not meet our needs/expectation. Please explain below.
Tuition was unaffordable.
Other, please explain below.
Additional information regarding your reason for withdrawal or cancelation.
What kind or extended care request would you like to make?
What kind or extended care request would you like to make?
New sign up for an ongoing extended care schedule
Change my child's ongoing extended care schedule
Cancel my child's ongoing extended care schedule
New sign up for occasional (i.e. non-recurring) extended care for a specific date
When would you like your new extended care schedule to begin?
(mm/dd/yyyy)
What is the last day you need your current extended care schedule?
(mm/dd/yyyy)
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.)
Monday
Tuesday
Wednesday
Thursday
Friday
none
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.)
Monday
Tuesday
Wednesday
Thursday
Friday
none
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.)
Monday
Tuesday
Wednesday
Thursday
Friday
none
If this is a temporary change (i.e. you'd like to add, change or cancel extended care temporarily) and then you'd like to revert to your current schedule, please enter the last date you would like this schedule.
(mm/dd/yyyy)
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.
I understand
For what day would you like to request extended care?
(mm/dd/yyyy)
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?
7:00 a.m.-8:00 a.m. (full hour)
7:30 a.m.-8:00 a.m. (half hour)
5:30 p.m.-6:00 p.m. (half hour)
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)
Begin ongoing lunch purchase schedule
Change current ongoing lunch purchase schedule or options
Cancel all ongoing lunch purchases
Order occasional (non-recurring) lunches for specific dates $9.25/lunch
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.
I understand
Does your child have food allergies?
Does your child have food allergies?
Yes
No
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.
All nuts
Almonds
Amaranth
Avocado
Barley
Cashews
Cinnamon
Coconut
Eggs
Fish
Milk
Oat milk
Sunflower
Oats
Peanuts
Peas
Pineapple
Pistachios
Poultry (FPIES)
Quinoa
Ranch Dressing
Rice
Rye
Sesame
Shellfish
Soy
Strawberries
Tahini
Tree nuts
Walnuts
Wheat
Other, please list below.
Please list any other food allergies.
Does your child have any dietary preferences or food restrictions?
Does your child have any dietary preferences or food restrictions?
Yes
No
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.
Dairy-Free
Halal
Kosher
No beef
No pork
Vegan
Vegetarian
Other, please explain below.
Please list any other dietary preferences or food restrictions.
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.
I understand
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)
Monday- Turkey Pepperoni Pizza Lunch
Monday- Cheese Pizza Lunch
Tuesday- Chicken Taco Lunch
Tuesday- Black Bean Taco Lunch
Wednesday- Veggie Patty Parmesan Lunch
Thursday- Chicken Fried Rice Lunch
Thursday- Tofu Fried Rice Lunch
Friday- Mac & Cheese Lunch
Friday- Pasta Marinara w/Chickpeas Lunch
When would you like your new lunch changes to take effect? (please note: changes are due Tuesday 5 p.m. to take effect the following Monday or later)
(mm/dd/yyyy)
What is the last day you would like to purchase lunches? (please note: cancelations are due Tuesday 5 p.m. to cancel lunches for the following week)
(mm/dd/yyyy)
Why did you change or cancel lunches?
Why did you change or cancel lunches?
My child didn't like the meals.
Meals didn't meet my child's nutritional needs.
Portion size didn't satisfy my child.
The lunch program is unaffordable.
Other, please explain below.
Please list any other reason(s) for changing or canceling lunches.
Please choose Monday of the week in which you would like to purchase occasional (non-recurring) lunches. (please note: orders are due on Tuesday 5 p.m. for purchases the following week or later)
(mm/dd/yyyy)
Which lunches would you like to purchase during the week indicated above?
Which lunches would you like to purchase during the week indicated above?
Monday- Turkey Pepperoni Pizza Lunch
Monday- Cheese Pizza Lunch
Tuesday- Chicken Taco Lunch
Tuesday- Black Bean Taco Lunch
Wednesday- Veggie Patty Paremesan Lunch
Thursday- Chicken Fried Rice Lunch
Thursday- Tofu Fried Rice Lunch
Friday- Mac & Cheese Lunch
Friday- Pasta Mariara w/Chickpeas Lunch
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?
Add or change extended care schedule for a Camp Go Blue session/week.
Cancel all extended care for a Camp Go Blue session/week.
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.
I understand.
Please indicate the first day of the session/week for which you are making this request or change.
(mm/dd/yyyy)
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).
Monday
Tuesday
Wednesday
Thursday
Friday
none
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).
Monday
Tuesday
Wednesday
Thursday
Friday
none
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).
Monday
Tuesday
Wednesday
Thursday
Friday
none
Please note: Registration fees for each session are non-refundable. Tuition is due for all sessions in which you enroll unless we recieve two 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 two weeks notice of cancellation.
I understand.
CGB Extended Care Cancelation: Please indicate the first day of the session/week for which you would like to cancel all extended care..
(mm/dd/yyyy)
Please indicate the first day of the CBG session/week for which you would like to cancel your child's enrollment.
(mm/dd/yyyy)
Miscellaneous Question and/ or Additional Comments
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Your first name
Your last name
Your email address
Verification Code