Parent Name

Address

City

Zip Code

Who will attend?

Nanny/Grandparent name

Home #

Cell #

Work #

Email address

Child # 1 Name

Birth Date

Tuition

Enter TIME

both 

1st & 2nd choice below

Child # 2 Name

Birth Date

Tuition

Total

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FORM

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Pick a PAY OPTION

/mo

NOTE:

Your place in class is RESERVED/assumed for the REMAINDER of the school year unless you WITHDRAW VIA EMAIL.

See special offer!!!

 

If paying via check, setting up automatic check payments through your bill-pay feature at your bank would be most appreciated. :) 

Due at the 1st class of the month.

OR

Pick a PAYMENT FORMAT

Enter TIME

both 

1st & 2nd choice below

$

/mo Sept-May ... pm classes Sept-Mar

Text Box: If 10% OFF option is chosen—payment by cash or check only

$

/mo Sept-May        PM&SAT Sept-Mar

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TUITION
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SAVE 10%

 

Pay up front for school year

 

savings of  $54

 

offer ends in September

Cash or check ONLY

no refunds

2000—2017