Periodic Review Form | Mt. Lebanon Extended Day Program (MLEDP)

Child's Name

First

Middle

Last

Center Location

Mt. Lebanon Extended Day Program is required by the DPW to have parents review their important information, at a six-month interval after enrollment.

Review your child’s information from your current Registration Schedule Payment Agreement and your Parental Consent & Emergency Contact Forms.

If you need to update the information on either of these forms, they can be found within the Registration Form on the MLEDP website, in the programs registration panel.

Registration Schedule Payment Agreement Form

I have reviewed my child’s information. All information is correct.

I have reviewed my child’s information and updates were required. I am providing MLEDP with a new Parental Consent & Emergency Contact Form along with this new Periodic Review Form. All information is now correct.