SUMC Preschool Application for Enrollment 2017-2018

PLEASE WRITE LEGIBLY
Child’s Full Name: / Date of Birth: / Gender:
Parent’s/Guardian’s Name: / Parent’s/Guardian’s Name:
([]) / ([]) / ([]) / ([])
Primary Phone / Secondary Phone / Primary Phone / Secondary Phone
Address: / Address:
City, ST ZIP Code / City, ST ZIP Code
Relationship to Student: / Relationship to Student:
E-mail / E-mail

On 8/31/17 my child will be ____years and months

/ Referred By:
Flex Classes Please circle your preferred days of attendance. Any requests for changes in schedule must be received in the office before the 20th of each month and are based on availability and are on a first come, first served basis.
Transitional 2’s Flex Class (2-5 days) MON TUES WED THURS FRI 3 yrs by 12/31/17Must be potty trained $200 $250 $290 $320
Transitional 3’s Flex Class (4-5 days) MON TUES WED THURS FRI 4 yrs by 12/31/17 $290 $320
3 Year Old Flex Class (2-5 days) MON TUES WED THURS FRI 3 yrs. by 8/31/17 $200 $250 $290 $320
Transitional Kindergarten (5 days) Monday – Friday 5 yrs. by 12/31/17 *Registration fee $225* $350
Please initial each of the following:
I understand the $125 registration fee for returning students and $175 for new students is non-refundable and holds my child’s place in his/her designated class and covers necessary startup expenses.
I understand tuition is, divided into 10 equal monthly payments beginning July 1st through April 1st and is subject to a 10% late fee after the 10th.Tuition must be paid by the last day of each month to continue to attend school the following month. Families who utilize the services at SUMC Preschool and Daycare must be in good standing on both accounts.
I understand that this school is a parent cooperative, and I will participate at least 2 days per month in my child’s classroom for the class period. If I do not meet my required co-op days, I will be assessed a $35 per missed day fee. *Limited non-cooperative spaces available for an additional $70 per month, please see Director for more information*
I understand this school is cooperative and requires 10 hours per year of participation on a school committee, and participation in 2 work days scheduled throughout the year on Saturday mornings. There is a $50 penalty for each work party missed, and a $200 penalty for non-participation in a school committee.
I understand that fundraising is an integral part of the schools operation and each family participates in fundraising efforts. I also understand that each family is responsible for $100 in the fundraising efforts for the school.
I understand the information on this application is used for classroom communication and will be published on a class list.
I understand that it is customary for students names and/or photographs to be used in classroom projects, newsletters, website, social media, school directory and other school communication and I will notify the school office in writing if I do not wish for my child’s’ name or image to be used.

Billing Information

Responsible Party E-mail Address
Responsible Party’s Signature Parent’s/Guardian’s Signature Date / Date

OFFICE USE: Registration Fee ___ Master List___ Accounting___ Constant Contact___ Phone tree ___

Date Submitted ______Class Assignment ______

SUMC Preschool 4140 N Miller Rd Scottsdale, AZ 85251 480-9460-0570