St. Stephen S Episcopal Preschool

ST. STEPHEN’S EPISCOPAL PRESCHOOL

82 Kimberly Drive

Durham, North Carolina 27707

(919) 489-6789

ENROLLMENT AGREEMENT

2017-2018

Please return this form with your enrollment fee and last month’s tuition (May 2018). Both the enrollment fee and May 2018 tuition are nonrefundable and nontransferable to any other month.

(The enrollment fee includes a registration fee, an activity fee and a supply fee.)

Your child is assigned to the following class: (May 2018 tuition/enrollment fee)

2 Year Old Class: Tues. & Thurs.______$210/$130 Mon., Wed. & Fri.______$255/$140

3 Year Old Class: Mon., Wed. & Fri.______$260/$155 Mon. – Fri. ______$340/$175

Pre K Class: Mon. - Thurs. ______$325/$175 Mon. - Fri.______$350/$175

(Four Year Old)

Name of Child: ______

Name To Be Called At School: ______

Address: ______Zip: ______

Home Phone: ______Date Of Birth: ______Sex: M/F (Circle One)

Parents: ______

Father’s Employer: ______Phone :(work)______(mobile)______

Occupation: ______

Mother’s Employer: ______Phone :( work) ______(mobile) ______

Occupation: ______

Church Affiliation: ______

Email Address: ______

The attached health form must be completed by your child’s physician and must be returned to St. Stephen’s Episcopal Preschool by the date listed on the form. The health form must be on file in the preschool office for your child to attend school. St. Stephen’s Episcopal Preschool complies with the N.C. State immunization guidelines.

Allergies: ______

Medical Conditions: ______

There are ______children in my family. This is number ______(oldest is number 1).

Has your child been in a nursery/preschool before? ______Name of school: ______

Will your child be enrolled in another preschool in addition to St. Stephen’s during the 2017-2018 school year? yes/no (circle one) Name of school:______

All children will be considered for admission to St. Stephen’s Episcopal Preschool regardless of race or faith. With exception to our two day two year old class, August 31 is honored as the birthday cut-off date for class assignment. December 31 is the birthday cut-off date for the two day two year old class.

Children with special needs will be considered for admission if to do so would not place an undue burden (significant difficulty, and/or expense) on the preschool program. If your child has any special needs (e.g. speech/language delays, fine and/or gross motor delays, physical limitations, behavior/emotional disorders) please list them on the back as well as any therapy your child is currently receiving. Admission to the preschool will be at the discretion of the Director.

Pre K students must be fully toilet trained to attend preschool. Five day three year olds need not be fully toilet trained at the beginning of the school year but must be in the process of toilet training. They must be fully toilet trained by November 1, 2017. Three year olds in the three day class need not be fully toilet trained at the beginning of the school year but must to be in the process of toilet training. They must be fully toilet trained by mid-January, 2018. Two year olds need not be toilet trained to attend preschool.

If you have any questions, please call the Director at 489-6789.

(over)

List special needs and therapy information here:

Please visit the preschool website www.ssesdurham.org to download a copy of the 2017-2018 Parent Manual. Click on the Parent Manual tab.

I have read all of the information on this form and agree that all the information I have given is accurate to the best of my knowledge. I acknowledge that I have reviewed the 2017-2018 Parent Manual and I understand that my child’s enrollment and attendance at St. Stephen’s Episcopal Preschool is subject to the policies and procedure set out in the Parent Manual. I further understand that St. Stephen’s Episcopal Preschool reserves the right to make changes to its policies and procedures at any time.

______

Parent Signature Date

Note: Discovery of any falsified information on the registration form will be taken to the Preschool Board for review. Immediate withdrawal of the child from the preschool may be considered.

St. Stephen’s Episcopal Preschool is a member of

The National Association of Episcopal Schools.