Fall ’10 Extended
Day Registration Form
*Only for students enrolled in the Morning Preschool Program
(August 25 – December 17)
Average of $15 Per Day
Little Panda Preschool Extended Day 12:30 - 4:00 pm
Student Name:
____________________________________
____ Mon. ____ Tues. ____ Wed. ____ Thurs. ____ Fri.
Birthday: ________________________ Age: ____ Sex: ____
Allergies: ________________________________________
________________________________________________
Home address:
Street: __________________________________________
City, State, Zip: ____________________________________
Home Ph: (_____)_____________
Parent Name: _________________ Cell: (_____)_________
Work Ph: (_____)____________ Email: ________________
Parent Name: _________________ Cell: (_____)_________
Work Phone: (_____)_________ Email: _________________
Emergency Contact
Name & Phone: _____________________________________________________
Because teachers are contracted for the full semester, families are obligated for the payments for the entire semester. The only exception is for families who move more than 50 miles away from DCS. Those families need to turn in a written notice 30 days in advance to receive a prorated tuition refund or waiver. No registration fee is necessary for this program. Please make checks payable to DCS.
Payment for the Fall‘10 Semester is as follows:
|
Payment |
1 Day |
2 Day |
3 Day |
4 Day |
5 Day |
|
1st due 8/1 |
$77 |
$154 |
$231 |
$308 |
$385 |
|
2nd due 10/1 |
$77 |
$154 |
$231 |
$308 |
$385 |
|
3rd due 11/15 |
$77 |
$154 |
$231 |
$308 |
$385 |
|
Total Payment |
$231 |
$462 |
$693 |
$924 |
$1,155 |
I have read
and agreed to abide this registration form.
Signature: ____________________________ Date: __________
Notice of Nondiscrimination Policy as to Students
DCS admits students of any race, color, national and ethnic origin to all the rights, privileges, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of any race, color, national and ethnic origin in administration of its educational policies, scholarship and loan programs, and athletic and other school-administered programs.