**Registration Fee
$50
++deposit
$100
date
MOUNT HERMON CHRISTIAN PLAY SCHOOL APPLICATION playschool@mounthermon.org ~ State of CA License #440706216 ~ 831-335-9420
Child’s Name: Child's Birthday
Name at school: Home Phone Month
Day
boy or girl Cell Phone
Year
Street Address Mailing Address
City City
Zip Zip
Father's Name
wk Phone
Cell Phone
Mother's Name
wk Phone
Cell Phone
Brother’s name(s) and age(s): 1. 2.
Sister’s name(s) and age(s): 1. 2.
Use the back if needed to complete the following information: Describe any allergies or health problems: Describe briefly your child's personality: What other group experiences has your child had? What church or spiritual experiences has your child had? How did you learn about Play School? • • •
The first four options below are for the regular Play School program. Option five is our Pre-K class with a little more emphasis on readiness skills. Fees subject to change
Check your choice
Class Name
Age Requirement
Days of Class
**Ladybug Ladybug **Butterfly Butterfly Pre-K
3 by September 1st 3 by September 1st 4 by September 1st 4 by September 1st 4 ½ by September 1st
Tuesday & Thursday Tuesday & Thursday Mon. Wed. & Friday Mon. Wed. & Friday Mon. Wed. & Friday
Times 9 – noon 9 – 1 PM 9 – noon 9 – 1 PM 9 – 1 PM
Fee $280/month $360/month $400/month $500/month $550/month
Please send me an application for a scholarship. NOTES: No scholarships for Pre-K. Half of tuition is most possible. **For children new to Play School there is a $50 non-refundable registration fee. ++In addition to the registration fee there is a deposit of $100, which will be credited to the May tuition (last month). If for any reason you leave Play School before the end of the year, the $100 is non-refundable. **EXCEPTION: children on scholarships and/or financial assistance; the $100 is non refundable and is NOT applied to May. The payments agreed upon are the same all 9 months. The monthly fees listed above are to be paid at the beginning of each month. These rates are effective for the school year of September through May, and do not change even if we have a school cancellation due to weather, staff illness, etc., or you have vacation or extended illness. Think of it as rent for your space at Play School.
Checks are to be made payable to: Mount Hermon Association. Please return this application to: PLAY SCHOOL, Kahleen Edeal, P.O. Box 413, Mount Hermon, CA 95041 (PS 1) KE 4/10