Perpich Arts High School Financial Responsibility

Student Legal Name: ______

Last First Middle

Parent or Guardian Legal Name: ______

Last First Middle

Parent or Guardian Legal Name: ______

Last First Middle

The student’s accounting file will be established using the name of the parent/guardian whose social security number is listed below. Please list only one parent social security number.

Mother’s Soc. Sec. #: ______– OR – Father’s Soc. Sec. #: ______

Parent Social Security Number: Minnesota Statutes, Section 13.04, Subd.2, requires that, as a government agency, we must provide a Tennessen Warning to collect your social security number. Perpich Center for Arts Education intends to collect your social security number for the purpose of fee collection. Unless you pay your fees in full within 30 days of invoicing, you are required to provide your social security number to have your student admitted to Perpich. Your social security number will be kept confidential at Perpich and will only be provided to the Minnesota Department of Revenue if collection of outstanding fees is necessary.

Financial Responsibility

Parent(s) accept financial responsibility for all student fees or fines which may include acceptance, activity, parking, cafeteria and residential (if applicable) fees; and library fines. The fee schedule is listed in the student and parent handbook.

Parent or Guardian Signature: ______Date: ______

Parent or Guardian Signature: ______Date: ______

Please see backside of this form for student fee information.

Perpich Arts High School Student Fees 2013-2014

Dear Parent/Guardian: You will receive an invoice in early August that indicates the amount due. Payment options include: cash, check, or credit card. This is for information only — please do not send payment for the student fees outlined below now.

General Student Fees

Fee /

Amount

Activity Fee / $400
Vehicle Permit
/ $200

Activity Fees are used for school expenses such as art-related supplies, field trips, professional artists, graduation and student technology.

Transportation: Student cars in the lot are required to be registered with campus security by purchasing a parking permit. The parking permit must be visible in the car while parked in designated student lots. Parking permit forms are available in the orientation packet and at the Perpich front desk. Metro Transit bus passes also are available for purchase.

Note: Vehicles not properly registered with Perpich and/or not parked in designated areas are subject to penalties including fines and tow.

Cafeteria Fees

The prices of meals served in the cafeteria are listed below:

Meal /

Amount

Breakfast / $2.50
Lunch
/ $3.50
Dinner
/ $3.50
Adult Meals
/ $4.00

*Parents may monitor their student’s meal account balance via the TIES SchoolView system.

We participate in Federal Free and Reduced meals for breakfast and lunch. New U.S.D.A. guidelines require that a la carte items are available at an additional cost. “A la carte” means items in addition to the standard full meal. Additionally, if items from standard meals are omitted, remaining items are charged at the a la carte price.

Residential Fee

Fee /

Amount

Residential / $3,600

The Residential Fee is used for salaries of dorm staff, utilities and regular maintenance to the dormitory facilities.