Availability Request — Independence Assistance

Availability Request

Submit a schedule change request. All requests must be made at least two weeks in advance.

This page is designed for those that have changing availability — for example, students who begin a new class schedule, or caregivers whose summer schedule changes due to children not being in school.

First Name *

Last Name *

Date Change Should Start *

Email Address *

I have made this request 2 weeks in advance Schedule change requests must be submitted at least two weeks before the requested start date.

Requested Availability *

Enter your availability for each day using the format: 8a-5p, 12p-6p, or OFF

Sun

Mon

Tue

Wed

Thu

Fri

Sat

Notes

Submissions are sent directly to the office for processing.