Form preschool related printable 2026

1. Click ‘Get Form’ to open the Billing Form for Preschool Related Service Providers in the editor.
2. Begin with Section 1: Student Information. Fill in the student's name, NYC ID number, date of birth, and home district. Specify the related service provided and check the appropriate box regarding student assignment.
3. Move to Section 2: Provider Information. Enter your name, address, social security number, and telephone number as required.
4. In Section 3: Agency Information, provide your agency's name, address, telephone number, and federal tax ID. Ensure that an agency representative's name is printed clearly.
5. Proceed to Section 4: Service Provision. Document the dates services were provided along with group size, start and end times for each session. Obtain signatures from a parent or principal verifying service provision.
6. Finally, complete Section 5: Certification for Provision of Services by signing and dating where indicated. Ensure all information is accurate before submission.

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