Brilliant Minds Private School Enrollment Registration Form

YOU ARE VALUED! WELCOME TO Brilliant Minds Private SCHOOL Please Send Weekly or Daily ($25 daily)Tuition to $MyChildIsBrilliant via Cash App Please Include Cash App Fee of 5% per transaction OR PAY IN Cash or MONEY ORDER. PLEASE NOTE: FULL TUITION IS DUE EVEN IF THE STUDENT'S WEEK IS FRAGMENTED TUITION IS DUE ON EACH FRIDAY BEFORE NEW WEEK BEGINS. IN THE EVENT THAT TUITION IS NOT SUBMITTED ON THE FRIDAY PRIOR, $20 ADDITIONAL FEE PER DAY WILL BE ACCESSED AND MUST BE PAID PRIOR TO RETURNING TO SCHOOL 14550 New Halls Ferry Florissant MO 63033 Call. 314-643-7009

www.brilliantmindsprivateschool@gmail.com Please Complete Form In It's Entirely For Registration, Upload Tuition & Sign For Complete Submission
Scholar's Name (s)

First NameMiddle NameLast Name
Scholar's Name (s)

First NameLast Name
Scholar's Name (s)

First NameLast Name
Birth Date

MonthDayYear
Birth Date

MonthDayYear
Birth Date

MonthDayYear
Gender
Gender
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
FATHER NAME
MOTHER NAME
IMPORTANT EMAIL ADDRESS
Mobile Number
Format: (000) 000-0000.
Phone Number
Format: (000) 000-0000.
PLACE OF EMPLOYMENT & PHONE NUMBER FOR EMERGENCY
SCHOOL ATTENDED PRIOR TO ENROLLMENT AT BRILLIANT MINDS PRIVATE SCHOOL
Work Number
Format: (000) 000-0000.
GRADE LEVEL
GRADE LEVEL
GRADE LEVEL
Emergency Contact PERSON & Phone Number
Please Include Special Notes
Allergies
Please Include Special Notes
I AM AWARE THAT TUITION IS DUE THE WEEK **BEFORE** MY CHILD(REN) BEGIN SCHOOL IF MY TUITION IS NOT SUBMITTED BEFORE THE WEEK BEGINS I UNDERSTAND THAT I WILL HAVE TO PAY $20.00 FEE PER DAY. I THE EVENT THAT STUDENT IS ABSENT AND THERE IS A FRAGMENTED WEEK, ***FULL TUITION IS DUE. PLEASE FORWARD BRILLIANT MINDS TUITION VIA CASH APP: $MyChildIsBrilliant or $BrilliantMindsPrivateSchool; OR IN PERSON CASH OR MONEY ORDER PLEASE BE SURE TO RECEIVE A RECEIPT. Brilliant Minds Private School CLASS Hours of Operation: Monday -Friday 9:30AM - 3:00PM FREE BEFORECARE & FREE AFTERCARE (7:30AM-9:15AM) & (3:00PM-5:00PM) WE WILL CLOSED ON MAJOR HOLIDAYS (INFORMATION WILL BE GIVEN IN ADVANCED
PLEASE TYPE I UNDERSTAND
PARENT SPECIAL COMMENTS
Please Include Special Notes
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Brilliant Minds Private School Weekly Enrollment Registration if Discounted by Owner Please Mention In Comments if Given Permission
Brilliant Minds Private School Weekly Enrollment Registration

$120.00 Quantity

Subtotal

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Tax

$0.00

Total

$0.00
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File Upload (Shot Records, COPY of ID, PREVIOUS SCHOOL RECORDS, SPECIAL CUSTODY RECORDS & OTHER IMPORTANT DOCUMENTS

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