​​​​​​​​​​Forms & documents


To Register for MAP for 2022-2023:

MAP will be accepting 2022-2023 registration forms for NEW FAMILIES between Friday, February 15 and Friday March 4, 2022. 

MAP Registration forms are available by clicking on the links below. In order to register for MAP, families must know their child’s placement/schedule (Preschool—Jump Start or Kindergarten AM, PM or Full Day).  MAP does its very best to accommodate all families but in some cases, a lottery may necessary.  

Jump Start MAP 2022-2023:  a program at our North Street/Memorial School location for 4 and 5 year old children not yet in kindergarten, a fun & enriching experience for preschool aged children.   

Kindergarten MAP 2022-2023:  a program at our North Street/Memorial School location for children enrolled at the Memorial school in half day or full day kindergarten.  

Grades 1-6 2022-2023:  programming for children in grade 1 attending the Memorial school, children in grades 2 & 3 attending the Wheelock school, and children in grades 4, 5, and 6 attending either the Dale Street school or the Blake Middle School. 

The Executive Director will confirm your enrollment by asking for a two week refundable tuition deposit. Prior to starting MAP, you will be asked to complete a "Child Information Form" that provides us with contact information, authorized persons that you give permission for us to release your child with, along with emergency contacts and other important information that will help us care for your child.  Please feel free to contact Annette Gallagher with any questions @ 508.359.0003 or email: annette.map@comcast.net

Child Information Form

All families with children enrolled in MAP for 2022-2023 must complete a child information form prior to their child attending MAP.  This form can be emailed or mailed to MAP and is due by August 3, 2022. Click here >> for the Child Information Form

Developmental History

All JUMP START families enrolled in MAP for 2022-2023 must complete a developmental history prior to their child attending the program.  Jump Start families are also required to provide MAP with a copy of their child's current physical.  Both are due back to MAP by August 3, 2022. Click here >> for the Developmental History

Health Plans

In order to keep children safe at MAP, families with children having a health or medical condition, allergy, who take medicine at home or school, or who may need to have medication at MAP, are required to:  contact their child's program director, complete the appropriate plan/forms below, and have it signed by both the child’s licensed health care practitioner and the parent/guardian.  We ask that you have your practitioner complete and sign off on our MAP forms for consistency for our staff when accessing the information. Please read through the different descriptions of each form to choose the appropriate form that pertains to your child. If you have any questions, please contact your child’s Program Director.

Meghan Jackson                                                 Alex Sakash                                                       Kurt Jackson
JS- K-1 Program (508) 359-2165                         2-3 Program (508) 359-8513                               MAP @ Pfaff Program (508) 359-2168
Meghan.map@comcast.net                               Alex.23map@gmail.com                                   kurt14.map@gmail.com        

Families completing a Sever Allergy Action Plan or an Individual Health Care Plan for their child must set up a time to meet with their child's program director prior to the child's attendance at the program.  The purpose of this meeting is to review completed paperwork, drop off & train staff on medication administration (if any), and review health issues/concerns.

Severe Allergy Plan - For all severe allergies which require an antihistamine and/or an EpiPen.  

Individual Health Care Plan - For any chronic condition, other than severe allergies, which require medical treatment such as asthma, ADHD, diabetes, epilepsy,  and non-severe allergies  

Medication Consent Form - For both prescription and non-prescription medications that are NOT necessary for a severe allergy or a chronic condition. (examples: ibuprofen, antibiotics, etc.)  

Extra Day or Extended Day Form

Use the"Extra Day or Extended Day Form" form to request an extra day or to extend your child's regular day (for Jump Start or AM Kindergarteners).  Please consult your child's program director to assure space availability.  Click here>> for the extra/extended day form.

Schedule Changes

MAP requires 2 weeks written notice to make a schedule change (request additional day, drop days, or leave the program). Additional days are subject to space availability. Please email the Executive Director or your Child's Program Director to notify them of the change. Please be sure to notify your child's teacher & school of and schedule changes.

Site Specific Forms for 2nd-3rd Grade Site :

Site Specific Forms for MAP @ the Pfaff Site:

Upcoming Special Sign-up Days: (not available for Jump Start)

Click HERE for the information & ink to the sign up for the non-school days & MAP Special Sign Up Days 9/26 & 10/5