30–DAY TERMINATION NOTICE

The Children’s Center at CALTECH

286 S. Chester Ave., Pasadena CA 91106

Please complete this form if you are planning to withdraw your child(ren) from the Children’s Center at CALTECH.

Child:__________________________ Classroom:_______________________

Parent(s) name(s):_________________________________________________

Current phone number:_______________________

Last day at the Center will be:________________Reason for separation:____________

Forwarding address (if any):_________________________________________

________________________________________________________________

PARENT SIGNATURE__________________________TODAY’S DATE;____________

Please remember to subtract your initial deposit from your final month’s tuition check and submit it with this form to the office. Otherwise you may donate your initial deposit into our Student Family Tuition Assistance Fund. This fund is used to offset costs for young CALTECH families. If you have any questions regarding your closing tuition payment, your parent participation hours, or miscellaneous fees come to the office.