Update Information

Update Information
CHILD NAME*

First NameLast Name
What would you like to update ?*

1. Update your Contact information2. Update your Email and Phone numbers3. Update Credit cards4. Update your Children Shot records5. Step Up for Students6.VPK Certificate Upload
1- Update Your Contact information
Parents Name*

First NameLast Name
Who is filling the form ?*

FatherMother
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2- Update Your Email and Phone Numbers
Name*

First NameLast Name
Update Email *
example@example.com
Cell Phone Number*
Please enter a valid phone number.
Cell Phone Number 2
Please enter a valid phone number.
Home Number
Work Numbers
3- Update Your Credit cards
Name*

First NameLast Name
Please upload a picture of the both side of the credit card.

Cancelof
Expiration Date of Credit Card
Security Code of Credit Card
Billing Address for Credit Card*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Would like to Add secondary Credit Card
Secondary Credit Card (Optional)
Please upload a picture of the both side of the Secondary Credit Card.

Cancelof
Same as Billing Address for Primary Credit Card
Billing Address for Secondary Credit Card

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I authorize Young Kidz Academy to charge their card
4-Update Your Child's Shot Records
Childs Name*
Upload the Child's immunization and physical records here*

Cancelof
Add another child Details
Childs Name
Upload the Child's immunization and physical records here

Cancelof
Add another child Details
Childs Name
Upload the Child's immunization and physical records here

Cancelof
Add another child Details
Childs Name
Upload the Child's immunization and physical records here

Cancelof
Add another child Details
Childs Name
Upload the Child's immunization and physical records here

Cancelof
5. Step Up for Students
Reward Id # *
Reward Amount $*
Child Name

First NameLast Name
Parent Name

First NameLast Name
School Year*
Date Last School Enrolled

Young Kidz AcademyIf Other type School Name
Number Days Attended
Days Absent
Date withdrawn

MonthDayYear
Date
Course and Record of Achievement
Program Achievement
Date of Graduation

MonthDayYear
Date
School Address:

Street Address

Apartment/Unit #

CityState / Province

Postal / Zip Code
6. VPK Certificate Upload
if dont have VPK here where you apply

How do I qualify?
• Parents/guardians must be Florida residents.

• Children must turn 4 years old on or before September 1st of the current school year.

https://familyservices.floridaearlylearning.com/
Parent signature is required
The uploaded certificate must include your parent signature

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I confirm that I have signed the VPK certificate in the ‘Parent Signature’ section*

YESNO
“Please sign and upload a signed certificate.”

Parent Signature is required.
Should be Empty:

Update Information

1- Update Your Contact information

2- Update Your Email and Phone Numbers

3- Update Your Credit cards

Secondary Credit Card (Optional)

4-Update Your Child's Shot Records

5. Step Up for Students

6. VPK Certificate Upload