ABCAcademyDayCareCenterprovidesChildCareinJackson,Michigan

STUDENT CONTRACT
Junior Counselor Program
DATE______________________________


I wish to apply for ABC Academy's Summer Junior Counselor Program.

I wish to work at ABC Academy (circle location):
3210 Lansing Avenue
800 Laurence Street
2111 Emmons Road

I would like to work with (circle one):
Toddler
Preschool
Kindergarten

Name _____________________________

Date of Birth ____________________
Address ___________________________

School _________________________
City/State/Zip ________________________

Phone __________________________

I understand that I am committing to be at the center for all days and hours indicated below. If I must make a change in this schedule I will call my center and notify them as early as possible. I will return the required employment forms BEFORE I work. I have read the outline of the Junior Counselor Program and the "Guidelines for Living with Children" and agree to abide by them.
WEEK
ATTENDANCE DAYS
HOURS
June 12 - 16
M    T    W    TH    F
_____________________________
June 19 - 23
M    T    W    TH    F
_____________________________
June 26 - 30
M    T    W    TH    F
_____________________________
July 3 - 7
M    T    W    TH    F
_____________________________
July 10 - 14
M    T    W    TH    F
_____________________________
July 17 - 21
M    T    W    TH    F
_____________________________
July 24 - 28
M    T    W    TH    F
_____________________________
July 31 - Aug. 4
M    T    W    TH    F
_____________________________
August 7 - 11
M    T    W    TH    F
_____________________________
August 14 - 18
M    T    W    TH    F
_____________________________
August 21 - 25
M    T    W    TH    F
_____________________________

STUDENT SIGNATURE______________________________