Application for Admission 2010-2011

Child’s Name ________________________________________________ Known as: _________________

Last First

Birthdate __________________________ Language spoken at home ______________________ Gender______

Home Address:

Street _______________________________________ Town _____________________ ZIP_____________

Home Phone ____________________ Cell Phones: (Parent #1)______________(Parent # 2)________________

Parent #1 ______________________________________ Occupation ________________________________

Business Address ______________________________________ Telephone ___________________________

Parent #2 _____________________________________ Occupation _________________________________

Business Address ______________________________________ Telephone ___________________________

E-Mail ______________________________________

Other Emergency Contact _______________________________ Telephone ___________________________

Child’s previous school, if any ____________________ Green’s Farms Church Member? Yes______ No______

Sibling in program? Yes _____ No_____ All Siblings/Ages _________________________________________

Placement and Tuition Policies

· When a child is placed in any of the classes selected by the child’s parent/guardian, a contract is sent out.

· Placement is confirmed when the school receives both the signed contract and the required tuition payment of 33% of the annual tuition shown in the Class Selection section of this form. Unless prior arrangements have been made to accommodate special circumstances, this step must be completed by the date noted on the contract. Otherwise, the placement will be offered to another child.

· Balance of tuition is due in 2 installments: May 15 (33%); and October 15 (33% less the $200 paid with the application fee). The school reserves the right to add interest or appropriate fees for late payments of tuition.

· If the school cancels a class due to under-enrollment or any other reason, all tuition paid will be refunded in full.

· A registration fee of $250 must accompany this application. $200 of this fee will be applied to the last installment of the annual tuition. If the child remains on the waitlist and is not placed in a requested class by the opening day of school, $200 of the application fee will be refunded. Waitlists are maintained until September, and refunds for non-placement will be made at that time to parents. Refund requests will not be honored before the beginning of school unless approved by the Board of Directors. Otherwise, this $250 fee is non-refundable.

Applications will be processed on a first-come-first-served basis according to the postmark date on the envelope. All returning Fours and 5 Day applicants received within the initial postmark period will be placed first within their point category. No hand-delivered applications will be processed until after 1/4/10.

Indicate your class choices in order of preference. Your child will be placed in the highest possible of your indicated choices. Please do not mark any classes that you do not want or cannot accept.

The following fee schedule reflects 2010-11 tuition rates.

Four Year Old Classes – Children must be Four by December 31, 2010

5 Day A.M.	M-F 8:45-11:45	$6,800
3 Day A.M.	M/W/F 8:45-:11:45	$4,125
3 Day P.M.	M/W/F 12:15-3:15	$4,030
*4’s Extended 5 Day	M-F 11:45-1:40	$4,315
*4’s Extended 3 Day	M/W/F 11:45-1:40	$2,590
*4’s Extended 2 Day	T/Th 11:45-1:40	$1,725

*4’s Extended is an option that we are offering students who want & need a more comprehensive educational program. This program will highlight readiness skills for kindergarten and allow for a more in-depth involvement with the curriculum using a developmental approach to teaching. (Following the initial postmark period, any unfilled morning Fours spaces will become available to 3-day applicants requesting morning placement.)

Fours Selection: 1^st choice _________ + Extended ____ Day 2^nd choice ________ + Extended ____ Day

Three Year Old Classes – Children must be Three by December 31, 2010

*5 Day A.M.	M-F 8:45-11:45	$6,890
*5 Day P.M.	M-F 12:15-3:15	$6,760
3 Day A.M.	M/W/F 8:45-11:45	$4,125
3 Day P.M.	M/W/F 12:15-3:15	$4,030
2 Day A.M.	T/Th 8:45-11:45	$2,765
2 Day P.M.	T/Th 12:15-3:15	$2,730

*An option is to combine a 3 day & a 2 day program to create a 5 day program. This can enhance the educational experience as there will be curriculum continuity across the classrooms combined with the same quality teachers, therefore, allowing the children to explore topics more thoroughly. This could be ideal for older threes whose parents feel are “ready” for this broader experience. Within the initial postmark period, applications for 5 Day enrollment will be satisfied before three or two day placements are made.

Threes Selection: 1^st choice ________ 2^nd choice ________

Two Year Old Classes – Children must be Two by October 1, 2010

A Class	M/W/F 8:45-10:45	$5,300
B Class	M/W/F 11:00-1:00	$5,300
C Class	T/Th 8:45-10:45	$3,535
D Class	T/Th 11:00-1:00	$3,535
E Class	T/Th 1:45-3:15	$2,650

Twos Selection: 1^st choice ________ 2^nd choice ________

Parent’s Signature ________________________________________ Date ________________________

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For Office Use only: Date Received ___________ Check #/amount ________________ Placement_________

Revised 10/15/09