<p>FIRST BAPTIST CHURCH CHRISTIAN PRESCHOOL Enrollment Form- School Year 2011-2012</p><p>Please complete a separate Enrollment Form for each child. This enrollment form does not guarantee your child a slot within the preschool. Children will be enrolled on a priority basis, with first priority given to FBC Church members and current 2010-2011 First Baptist Church Christian Preschool families. Please list both your 1st and 2nd choices for class preferences. Upon receipt of this form and your $100.00 registration fee (non-refundable), you will receive an acceptance letter and your child’s position in the preschool will be confirmed. If you have any questions at any time, please feel free to direct those questions to Amanda Norris at 332-5732 or e-mail [email protected]. </p><p> Please submit a $100 non-refundable registration fee along with your enrollment form to the office of First Baptist Christian Preschool at 1939 Independence Blvd., 28403. Checks can be made payable to First Baptist Church Preschool. Applications will be numbered upon their return to the church office and should be submitted directly to Amanda Norris, Preschool Director.</p><p>CHILD’S INFORMATION</p><p>Last Name First M.I. Date</p><p>Street Address Name Called</p><p>City State ZIP E- Home Phone mail Current Age Birth Date Sex </p><p>Circle the class(s) you desire this year: M/W Toddlers T/Th Toddlers M/W/F Two’s T/Th Two’s M/W/F Three’s M-F Three’s M/W/F Fours M-F Fours</p><p>Has your child had previous group experience? Yes NO If so, where? Does your child have any allergies? Yes NO If so, explain?</p><p>FAMILY INFORMATION Parents’</p><p>Names Home Address </p><p>Dads Employment Moms Employment </p><p>Do both parents live at the above address? YES NO </p><p>If not, please Provide Additional Address </p><p>Dads Cell Moms Cell Other (relationship)</p><p>Other Children in the Family</p><p>Name Age Sex </p><p>Name Age Sex </p><p>Name Age Sex </p><p>FBC Church Member?</p><p>ENROLLMENT FEES AND TUITION ELIGIBILITY: There is a non-refundable registration fee of $100. The registration fee of $100 must accompany this form to complete your registration process. WE WILL REQUIRE A CURRENT COPY OF YOUR CHILD’S IMMUNIZATION RECORD. AGREEMENT: Upon enrollment of my child, I agree to: Make tuition payments by the 1st of the month. I also absolve First Baptist Church and the First Baptist Church Christian Preschool from any financial responsibly in case of injury or illness of my child.</p><p>Signature Date</p><p>Page 2 ►Please mark your first choice as 1 and your second choice as 2.</p><p> Toddler Class: $155 / month Age 1 before August 31st, 2011, but not 2 before August 31st, 2011</p><p>_____ Monday/Wednesday</p><p>_____Tuesday/Thursday</p><p> Twos Class: 3 days a week $175/ month 2 days a week $155 / month Age 2 before August 31st, 2011, but not 3 before August 31st, 2011 </p><p>____Monday/Wednesday/Friday _____Tuesday/Thursday</p><p> Threes Class: 3 days a week $175.00 / month 5 days a week $200 / month</p><p>Age 3 before August 31st, 2011 but not 4 before August 31st, 2011 </p><p>_____ Monday/Wednesday/Friday _____Monday - Friday</p><p> Fours Class: 3 days a week $175 / month 5 days a week $200 / month Age 4 before August 31st, 2011, but not 5 before August 31st, 2011</p><p>_____Monday/Wednesday/Friday _____Monday – Friday</p><p> Class Time is from 9:00 am until 12:00 pm * Carpool begins at 8:45 and 11:45 respectively</p><p>►How did you hear about First Baptist Church Christian Preschool? </p><p>______</p><p>______</p><p>►Are there any special concerns regarding your child that we should know about?</p><p>______</p><p>______</p><p>______</p><p>First Baptist Church Christian Preschool Mission Statement The mission of First Baptist Church Christian Preschool is to provide excellence in preschool care for children in our community with a loving, Christ-centered environment that fosters the whole child in every area of development.</p><p>Received by: ______Date: ______Time:______#: ______</p>