3 Year Old Children

PRESCHOOL REGISTRATION For 3 Year Old Children

Child’s Name: Sex:

Parents email address: ______Age on September 1: Child’s SS#: Phone: Address: Place of Birth: Date of Birth: How did you hear about our preschool? ______Child’s religion: Are you a registered parishioner of St. Mary’s Sycamore? ______Child lives with: Both Parents Mother Father Relative Guardian Stepmother Stepfather Other

If divorced, who has legal custody? Do you have joint custody? Y/N Name of Person: If no, certified copy of custody agreement must be attached to this form. Please list other children in your family: Name: ______Age: ______Name: ______Age: ______Name: ______Age: ______Name: ______Age: ______

This form is not intended to constitute nor should it be viewed as creating a “contract” between the School and the student/parent. The School reserves the right to revoke its acceptance of the application, deny enrollment and/or dismiss the student in keeping with applicable School and/or Diocesan policies. Father’s Name: Address: Phone: Place of Birth: Occupation: Employer: Work Phone:

Married Divorced Separated Deceased Remarried Single

Mother’s Name: Address: Phone: Place of Birth: Occupation: Employer: Work Phone:

Married Divorced Separated Deceased Remarried Single

If applicable, please check one and complete the following information: Stepfather Stepmother Guardian Other Name: Address: Phone: Place of Birth: Occupation: Employer: Work Phone:

Registration fee of $ 75.00 Paid by check # Cash Birth Certificate Attached Yes No

All registration forms are due back in the school office by May 15th

Rev.2/2017 PRESCHOOL TUITION COMMITMENT SHEET 2017-2018

Family Name: Child’s Name: Birth Date: Child’s Name: Birth Date:

3 Year Old meets Tuesday and Thursday from 8:30 a.m. – 11:30 a.m. Your child must be 3 by September 1st.

Tuition Rate for 3 Year Old Preschool is $130.00 per month. You will be billed monthly.

Payments are due by the first of the month. If payments are not made in a timely manner, continued enrollment will be denied.

I have read this commitment sheet carefully and understand my obligation.

Signature of person(s) responsible for payment of preschool tuition. Signature of both parents/guardians is required where applicable.

Signature Date Signature Date