80 Hilltown Pike, P.O. Box 217, Line Lexington, PA 18932

Hilltop Preschool Application For Enrollment

Phone: 215-822-0565

Home Address: ______Town______Zip______

Home Phone: ______Birth Date: ______Circle: M F

Name: Mr/Mrs/Ms______Phone #______

Name: Mr/Mrs/Ms______Phone #______

Home Address (If different from above): ______Cell #______

E-mail address: ______School District where you reside:______

Any special concerns we need to be aware of?______

Sibling(s) names and ages: ______

Has your child had any previous school experiences? Y N If so, where ______

How did you hear about us? ______

CLASS DESIRED: * All children must be potty trained before beginning school

______2-Day Mornings – Tues. & Thurs. (3 & 4 years old)

______2-Day Afternoons – Tues. & Thurs. (3 & 4 years old)

______3-Day Mornings – Mon., Wed. & Fri. (4 & 5 years old)

______3-Day Afternoons – Mon., Wed. & Fri. (4 & 5 years old)

(Morning Classes: 9:00–11:30 AM, Afternoon Classes 12:30-3:00 PM)

______Pre-K Morning Only, 9:00 am-12:00 pm – Mon.-Thurs. (Must be 5 years old before Dec. 1st)

$100.00 DUE WITH APPLICATION TO RESERVE SPOT FOR THE FOLLOWING YEAR – NON REFUNDABLE

(Fee consists of $50.00 registration fee & $50.00 “Good Faith” deposit applied towards first tuition payment.)

$130.00 Tuition per month for 2-Day programs + $30. annual activity fee (Payments from August to April)

$155.00 Tuition per month for 3-Day programs + $60. annual activity fee (Payments from August to April)

$200.00 Tuition per month for Pre-K program + $80. annual activity fee (Payments from August to April)

*Tuition payments are due the 15th of each month, beginning in August.

(There is a $5.00 late fee charged for payments received 7 days after the due date.)

*No adjustment for illness, except for extended periods.

*Hilltop Preschool accepts students of any race, color or ethnic origin.

Signature of Parent or Guardian: ______Date: _________