Form For Parents That Leave Your Daycare (On Good Terms)

[WImom]

Does anyone use a form or survey to ask parents what they thought of your daycare and ask for a short reference paragraph? I was thinking of doing something like this to have refrences at interviews besides just the normal phone numbers of clients.

Not sure what to include or write?

[frugalmama4]

I do

Notice of Withdrawal Form


I am submitting my two week notice of withdrawal for my child /children _________________________________from ***X Child Care

Effective __________, 2012 the last date of service will be ____________________.


By signing below, I, _________________________________ acknowledge the following.
Parent/Guardian

Please initial all that apply:

___I have provided the required 2 week s (per-child) written notice.

___I have received all belongings.

___ I have paid all outstanding tuition and/or fees in full prior to the last day of care.

___There will not be any action (legal or otherwise) taken against ***X Child Care its owner and/or any of its affiliates.


Mother/Guardian Signature: ___________________________ Date: _____________

Father/ Guardian Signature: ____________________________ Date: _____________

Provider Signature: ___________________________Date: _____________


To help us serve our families better and continue growing, please answer the following.

Reason for leaving: __________________________________________________

__________________________________________________________________

Would you refer us: _________ If no why not:___________________________

Would you use us again: ______If no why not:___________________________

Comments or Suggestions: _________________________________________

_________________________________________________________________________

Once I receive notice I usally send this form via email (in PDF file) a few days before the last day of care. I have it on my letter head.
Hope this helps