APPLICATION FOR SCHOLARSHIP Mount Hermon Play School P.O. Box 413, Mount Hermon, CA 95041, 831-335-9420
Child’s Name:
Date Please circle the class your child will attend:
Ladybug (T, Th) 9:00am-12:00pm
Butterfly (M,W,F) 9:00am-12:00pm
Monthly tuition:
Monthly tuition:
Scholarships are available on a limited basis and never awarded for more than half tuition. It is expected that families will contribute towards the cost to the extent of their personal ability. Scholarships are only available for the 9:00am-12:00pm option in each class. For pre-K, scholarships are only available for 3rd year students or children age 5 by September 1st.
Instructions: 1.
In order for your request for a scholarship to be processed, please be sure the following items have been completed: • The Play School application has been submitted to the Director. • The registration and deposit have been paid. If you are awarded a scholarship and/or financial assistance, both the registration and deposit are non refundable. Plus the deposit does not go toward the May tuition; your payments are the same for all nine months. If you enroll the following year a $100 deposit is due again at registration. • Answer the following questions, sign and date at the bottom. • Return to the Director by Friday, September 4, 2009.
2. Submit this form by mailing to the address above, attention Kahleen Edeal. ******
Per Month Total fees for your class: 9-noon TTh Ladybug / MWF Butterfly
For the Year x9
= -
x9
Total
=
x9
Amount you said you could pay
-
x9
Total = Scholarship amount requested
=
x9
Mt.H.Employee 20% discount
(For the following questions, please use the back of this paper if necessary.) Please state briefly the circumstances making assistance necessary:
Please Print Your Name: Parent/Guardian
PS 04 (KE 8-2009)
Signature of Parent/Guardian
Date
Phone
OFFICE USE: Processed by: Date
PS 04 (KE 8-2009)