HERITAGE MONTESSORI SCHOOL

310 Lake Street South, Big Lake, MN 55309

Enrollment Contract – Elementary School Year 2017 – 2018

Child ______(M / F) Birth date ______Phone ______

Address ______City ______Zip ______

Mother’s Name ______Social Security # ______

Father’s Name ______Social Security # ______

Address if different (Mom) (Dad) ______email (Mom) ______

Phone if different (Mom) (Dad) ______email (Dad) ______

Please check your option below:

_____ $595 Elementary Class Only [8:00 – 3:00]

_____ $635 Before School Care + Class [6:45 – 3:00]

_____ $660 Class + After School Care with 4:30 pick-up [8:00 – 4:30]

_____ $700 Class + After School Care with 5:30 pick-up [8:00 – 5:30]

_____ $715 Before School Care + Class with 4:30 pick-up [6:45 – 4:30]

_____ $750 Full Day + Class [6:45 – 5:30]

Usual arrival time: ______Usual pick-up time ______*Note: There is a late fee charged for late pick-up.

Tuition: Tuition per month, payable the first of each month $______. Students whose accounts are not paid by the 5th of the month will not be allowed to attend class until payment is made. There is $15 late tuition fee.

_____ $25.00 Placement Fee Enclosed (Returning students only: Non-refundable; Not applied to tuition)

Registration Fee for NEW Students: A $100 non-refundable fee is required with each student’s first contract.

_____ enclosed Check # ______Cash ______

Lunch: Students bring their own lunch. Milk: $45 yearly milk fee [optional] Paid ______

Workbooks: $225 [subject to change] Paid _____

The school does have liability insurance, which is renewed annually at the end of February and a certificate of coverage is available for inspection upon written request.

I have read and agree to the school tuition policies. I understand that I must pay tuition for four (4) weeks following written notification regardless of whether or not my child attends. If the school finds it necessary to have my child withdraw for any reason, I am not responsible for any tuition beyond the day of withdrawal. The school may request withdrawal of my child if they determine that the program is an unsuitable match for my child. I understand that some months will have more school days than others and school will be closed for holidays and staff training; but the fee remains the same.

The undersigned agree that they are both jointly and separately responsible for tuition.

______

Mother’s Signature Date Father’s Signature Date