EmailMeForm
Daycare Closure Notification
This form is used to notify food program sponsor of daycare closures.
Name of Daycare
*
City
*
Name of Employee Reporting Closure
*
First
Last
Reason for Closure
*
Please select
Covid-19
Weather
Other
If Covid Related, who tested Positive
Enrolled Child(ren)
Staff
Other
Date of Closure
*
MM
/
DD
/
YYYY
Date of Estimated Re-Open
*
MM
/
DD
/
YYYY
Additional Notes or Comments
