Important Forms

If you are unable to print the following forms, your Site Coordinator can provide a copy for you.

Health Related Forms

Click the links below to view or print the forms

Authorization to Administer Medications. If your child will need medication during program, you must complete this form and give it, the medications, in original container, with prescription label.

Asthma Action Plan. If you child has asthma, please have your health care provider complete this form, or provide the asthma action plan your provider has created for your child.

Allergic Reaction Action Plan. If you child has allergic reactions that might require attention and medication, please have your health care provider complete this form, or provide the allergic reaction plan your provider has created for your child.

Anaphylaxis Action Plan. If your child has the potential for an anaphylactic reaction, please have your health care provider complete this form, or provide the anaphylaxis action plan they have created.

Child Care Financial Assistance

Click the links below to view or print the form

Application for Vermont Child Care Financial Assistance. Please complete this form, and return to Child Care Support Services at the Vermont Achievement Center. 88 Park Street, Rutland, VT 05701

Free or Reduced Meals Application

Many families are not aware that our program's ability to qualify for federal and state grants depends on the number of familie in our school that might qualify for free or reduced meals. Universal meals has greatly impacted our ability to demonstrate potential need, and to be eligible for many grants supporting programs like After School. We would very much appreciate if you are willing to complete this form to help us qualify for additional grant funding form programs.

Click the links below to view or print the form

Free or Reduced Meals Application. Please complete this form, and return to your child's school office.

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