2021-22 CDS Registration Form

2021-22 St.Paul's Christian Day School Registration
Student Name *

First Name Middle Name Last Name
Birth Date *

Month Day Year
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Gender *
Mother's Name *

Name Cell Phone
Mother's Place of Employment *

Place of Employment Work Phone
Mother's Email Address *
example@example.com
Father's Name *

Name Cell Phone
Father's Place of Employment *

Place of Employment Work Phone
Father's Email Address *
example@example.com
This gives us permission to print the above information in the student directory. *
Enroll my child in this class: *
Please Select Class in drop down menu
Ex Care Needed

Full Time Part Time

Click Extended Care Needed if Part Time

Morning
(7:15-11:30)

Lunch Bunch
(7:30-1:00)

Lunch & Afternoon
(11:30-5:30)

After School
(3:30-5:30)

Study Hall Only
(3:30-4:30)

Monday

Tuesday

Wednesday

Thursday

Friday

This is a place to add a schedule option that you may need. blanks
Check your payment request: *

BILL Full Registration Fees to My Day School ProCare Account to be applied with my tuition February 10, $450.00 (less $25.00 for church member in good standing) Bill ProCare in 2 installments . Payment #1 February 10 $225.00, #2 March 10 Bill ProCare in 3 Installments Payment # 1 February 10 $150.00, #2 March 10, #3 April10 Will bring Cash or Check Payment by CDS Office
Your signature below states that this form information is accurate.
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