Request Change to FACTS The form will go to designated people (not a public form) who will use it to request changes to enrolled children’s information in FACTS tuition or FACTS SIS online enrollment system Choose your school:*USASUSDLYour Name* First Last Childs Name* First Last Child's Birth Date* Parent's Name, if different from child First Last Age*6 weeks12 months18 months2's3'sPrimary Prep (4's)Early Primary (5's)Reason for Change (Choose Only One)* New Student New Camp Student Increase in Days Decrease in Days Incentive Rebate State Scholarship Change Upbring Scholarship Change Withdrawal (use online withdrawaal form) The family is aware that these changes are being made:*YesNoa. If no, please enter your plan to share these changes with the family along with the timeline for sharing.Additional DetailsNEW STUDENTEnter Start Date Type of StudentAcademic Only (short day, no holiday, no summer, 10 months)Full Program -12 months (all times, summer, holidays)Full Program - 10 months (all times, no summer, holidays)Sibling of Current Student?YesNoa. Enter Name of current studentb. Class of current studentNEW CAMP STUDENTCamper (which weeks?) Spring Break Thanksgiving Break Winter Break Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10 Week 11 Week 12 Week 13 What is their rate per week?INCREASE IN DAYSPrevious number of days5 Days3 Days2 DaysNew number of days5 Days3 Days2 DaysDate this change is effective DECREASE IN DAYSPrevious number of days5 Days3 Days2 DaysNew number of days5 Days3 Days2 DaysDate this change is effective Incentive RebateName of Child Referred First Last Start Date Is this child 5 days a week?YesNoDoes this child pay the full rate?YesNoState Scholarship ChangeNew monthly parent portion: (if none, enter 0)Date Activated Notes about this change:Upbring Scholarship ChangeDate Scholarship was approved Approved by:Monthly amount of scholarship to be applied:Date to activate Notes about this change:WithdrawalPlease have the parent complete the withdrawal form which is found on the current families pages of the Upbring school web page.Date of withdrawal Parents Email Enter Email Confirm Email This iframe contains the logic required to handle Ajax powered Gravity Forms.