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MEDWAY PUBLIC SCHOOLS PRESCHOOL PACKET In this packet you will find: ● Cover letter with Registration Checklist ● Application for Preschool ● Agreement for Preschool Tuition ● Registration Form ● Medway Student Health History ● Home Language Survey ● School Calendar ● School Hours and Addresses ● Communication from School Nurse ● Free and Reduced Lunch Application ● Vaccination Exempt Form MEDWAY PUBLIC SCHOOLS REGISTRATION CHECKLIST Welcome to Medway Public Schools! Please complete New Student Registration Packet which includes: ● Registration Form ● Emergency Information Form ● Health History Form ● Home Language Survey In addition to the forms above, the following documents are required: ● Proof of residency: ○ Utility bill ○ Signed Purchase and Sale (occupancy must take place within sixty (60) days) ○ Current Tax Bill ● Birth Certificate ● Copy of most recent physical exam - should be dated after January 1 of year of registration. ● An immunization record from the physician ● A copy of current 504/IEP plan (if applicable) ● Legal court documentation of guardianship (if applicable)- If divorced or separated, you will need to show legal or official court documentation indicating that you are the custodial parent and have physical custody of your child. ● Free and Reduced Price School Meals Application (if applicable) Please note that all of the above must be presented to complete the registration process: NO child will be able to register without all documentation. All completed documents should be delivered at time of registration: Registration will be held in the Library of the McGovern Elementary School on Lovering Street Tuesday, February 27, 2018 from 3:30 p.m. to 6:00 p.m. Saturday, March 3, 2018 from 9:00 a.m. to 12:00 p.m. MEDWAY PUBLIC SCHOOLS Medway, MA 02053 TUITION-FUNDED INTEGRATED PRESCHOOL PROGRAM 2018-2019 APPLICATION Please enter my child's name in the full or half day, tuition-funded integrated preschool program. I understand this program requires a tuition payment due each month prior to the month of attendance. Please hold onto this form and deposit until May 1 Please note: ● Child must be 3 years old to be eligible; or 4 years old by August 31, 2018 to be eligible for consideration of Full Day. ● Child must be properly registered through the Superintendent’s Office. ● Faxes will not be accepted. ● A non-refundable payment for the full-day integrated preschool will be du​ e in the amoun​ t of $470.00 after May 1, 2018. ● A non-refundable payment for the half-day integrated preschool will be du​ e in the amoun​ t of $475.00 after May 1, 2018. ● Signed Agreement Form for Full-Day or Half Day Tuition-Funded Integrated Preschool must accompany this application. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Please print: ​ Date: ____________________________ Child's Name: ___________________________________________________ Parent/Guardian Name: _________________________________________ Address: ________________________________________________________ Home Telephone: ________________________________________________ Work Telephone: ________________________________________________ Cell Phone: _____________________________________________________ Email: __________________________________________________________ ______________________________________ Parent/Guardian Signature Make check payable to: Medway Public Schools Return this form, non-refundable payment of $470.00 for full-day integrated preschool and $475.00 for the half-day integrated preschool. Agreement Form after May 1, 2018 Medway Pub​ lic Schools Attn: Business Office 45 Holliston Street Medway, MA 02053 Medway Public Schools Medway, MA 02053 AGREEMENT for FULL or HALF DAY TUITION-FUNDED INTEGRATED PRESCHOOL 2018-2019 I.Understanding of My Payment Obligation ​ In order for my child to be enrolled in the full-day integrated preschool, I hereby agree to pay the annual tuition of ​ ​ ​ $6,550.00 payable by an initial deposit of $470.00 by May 18, 2018, with the balance due in eight (8) monthly ​ ​ ​ installments of $760.00 submitted by the 15th of each month prior to the month of attendance; the first installment ​ th ​ ​ is due on August 13 ,​ 2018. ​ In order for my child to be enrolled in the half-day integrated preschool, I hereby agree to pay the annual tuition of ​ ​ ​ ​ $3,275.00 payable by an initial deposit of $475.00 by May 18, 2018, with the balance due in eight (8) monthly ​ ​ ​ installments of $350.00 submitted by the 15th of each month prior to the month of attendance; the first installment ​ th ​ ​ is due on August 13 ,​ 2018. ​ I understand that if I fail to make a tuition payment and my account is in arrears two payments, (60) sixty days, my child will automatically lose his/her seat. Additionally, I understand that the tuition fee will not be modified to reflect any absences incurred by my child during the course of the school year. I understand that if payment for this program is creating a financial hardship I will notify the superintendent’s office immediately and apply for a waiver or reduction in fee based upon school committee policy and the free and reduced lunch program guidelines. However, in the event that I am not eligible for a waiver or reduction in fee that I will continue to make payments or my child will be removed from the program. I understand that should I remove my child from the program, or the school department removes my child from the program due to non payment, I will still be responsible for tuition pro-rated for the time my child participated in the program. Payments must be in the form of a check or money order made payable to “Medway Public Schools.” Checks should ​ ​ be delivered or mailed to the Business Office, 45 Holliston Street, Medway, MA 02053. The Town Treasurer will assess a $25.00 charge for checks returned for insufficient funds. II. Understanding of My Child’s Participation in the Program I understand that my child’s full or half-day integrated preschool seat is not transferable. I understand the full or half-day integrated preschool will not be considered an academically accelerated program, nor will the teacher follow an advanced grade level curriculum. I understand the tuition-funded, full or half-day integrated preschool is for regular education students and that several special education students will be assigned to each full or half-day integrated preschool section by the school. I understand my child is expected to follow all reasonable rules and expectations for student conduct; inappropriate behavior may result in exclusion from the tuition-funded kindergarten program. III. Acknowledgement I have read and understand the above terms and conditions under which my child, (print student’s name) __________________________________________________, is admitted to the tuition-funded, ​ full or half-day integrated preschool program, and I hereby agree to these terms and conditions. ​ ​ ___________________ _____________________________________________ (Date) Parent/Guardian Signature _____________________________________________ Print Parent/Guardian Name Please return this completed form at the time of registration. Medway Public Schools Medway, MA NEW STUDENT REGISTRATION Please print: Date: _______________________ School Year: _________________ Grade Entering: _________________ PART A Student’s Full Name: _______________________________________________________________________________ (Last name) (First name) (Middle name as it appears on Birth Certificate) Home Address: ___________________________________________________________________________________ (Street) (City/town) (Zip) Home Phone: ___________________________________ Sex: Male Female Date of Birth: ______________________________ Birth City/State: _______________________________________ Previous School Information Last School Attended: _______________________________________ Grade: _______________________ City/Town: ________________________________________________ State: ________________________ Please check any additional services the student was receiving: Student has an Individual Education Plan Student has a 504 Plan Student was receiving LEP Services Student was receiving Title I Services Part B Parent/Guardian #1: _______________________________________________________________________________ Address if different: ________________________________________________________________________________ (Street) (City/town) (Zip) Please Provide all of the below information and check box to indicate primary contact number during school hours Home Phone _______________________ Work Phone ____________________ Cell Phone ________________________ Email _________________________ Parent/Guardian #2: _______________________________________________________________________________ Address if different: ________________________________________________________________________________ (Street) (City/town) (Zip) Please Provide all of the below information and check box to indicate primary contact number during school hours Home Phone _______________________ Work Phone ____________________ Cell Phone ________________________ Email _________________________ Part C With whom does student reside? Both Parents Mother Father Guardian Other Who has legal custody of this student? Both Parents Mother Father Guardian Other Is there any other legal information that the school should be aware of? Yes No If yes, documentation is required. Is anyone restricted from contacting this child? Yes No If yes, documentation is required. Has this student ever attended Medway Public Schools?

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