Harvey Browne Preschool

HARVEY BROWNE PRESCHOOL

REGISTRATION FORM

Date of Application______PLEASE READ CAREFULLY I hereby make application for the admission of my child to Harvey Browne Preschool. Along with this application, I am paying a registration fee.

I agree to pay tuition for the entire school year on May 1, or in three installmentsdue on May 1, October 1, and February 15 or monthly May1-February 1. I understand that NO PORTION of the registration fee or tuition is refundable.

Child’s Name______Child’s Gender M or F

Name Child is Called______Date of Birth______

Address ______Zip Code ______

Phone ______E-mail address ______

Mother’s Name ______Father’s Name______

Child lives with: ______

Father’s Employer ______Phone ______

Mother’s Employer ______Phone ______

List siblings (and ages) living in home with child:______

______

General Health/Allergies (food,animals)______

Any special needs or services? (emotional, physical, learning disabilities)

______

Child has had chicken pox? yes no Child has had Measles? yes no

Child’s Physician ______Phone ______

Previous Schools Attended ______

Have siblings previously attended Harvey Browne? ______

Harvey Browne Memorial Presbyterian Church Member? yes no Would you like to be contacted by someone to learn more about the church? yes no

Signature ______

Over

Child’s Name______

Please mark the class you prefer

If you have a 2nd or 3rd choice, please number your choices indicating 1st choice, 2nd, choice etc.

____Kindergarten – Meets Monday –Friday. In October, children begin staying until 3:00 p.m. on Thursdays. In January, children stay until 3:00 p.m. on Tuesdays and Thursdays.

___5 day Four Year Old Class – Meets Monday – Friday

___4 day Four Year Old Class – Meets Tuesday – Friday

___4 day Four Year Old Class Plus Enrichment - Meets Monday - Friday

___3 day Four Year Old Class Meets Monday- Wednesday- Friday

___3 day Four Year Old Class - Meets Tuesday, Wednesday and Friday

___3 day Four Year Old Class plus Enrichment – Meets Monday,

Tuesday, Wednesday and Friday

___3 day Three Year Old Class – Meets Monday, Wednesday and Friday

___3 day Three Year Old Class plus Enrichment Meets Monday, Tuesday, Wednesday and Friday

___2 day Three Year Old Class – Meets Tuesday and Thursday

___2 day Three Year Old Class – Meets Monday and Thursday

___2 day Three Year Old Class plus 1 day Enrichment – Meets Monday,

Tuesday and Thursday

___2 day Two Year Old Class – Meets Tuesday and Thursday

The enrichment class will meet on Monday or Tuesday and is a class full of enriching, hands-on engaging activities for 3 and 4 year olds. There will be activities in art, movement, author studies, problem solving, science experiments and more! Enrichment is a class you sign up for the entire year. When you are calculating your tuition, include the morning of Enrichment in the calculation (i.e. 2 day Three Year Old Class plus enrichment=3 mornings)

Tuition Prices –
Kindergarten - $3840 / 3 mornings -$2580
5 mornings - $3450
4 mornings -$3060 / 2 mornings - $2220