Pender Hill School Registration

Pender Hill School

12401 Alder Woods Drive

Fairfax, VA 22033

Questions? Call 703-352-6204

2023-2024 Registration

Child's Name*

First NameLast NameNickname

Date of Birth*

Date

Gender*

MaleFemale

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Mom's Name*

First NameLast Name

Mom's Home Phone Number*

Area CodePhone Number

Mom's Cell Phone Number

Area CodePhone Number

Dad's Name*

First NameLast Name

Dad's Home Phone Number*

Area CodePhone Number

Dad's Cell Phone Number

Area CodePhone Number

Preferred Email*

example@example.com

What language is spoken at home?

Does your child understand English?

YesNo

Does your child have any special needs? If so, please list them here.

Does your child have any allergies? If so, please list them here.

Available Classes. Please Check One

Our program accepts all children without regard to race, color, creed or religion.

2 Year Old

1 Day (W) Tuition $165, Supply Fee $30, Child Must Be 2 by 9/30/232 Day T/Th) Tuition $330, Supply Fee $60, Child Must Be 2 by 9/30/23

3 Year Old

3-Day (T/WTh) Tuition $298, Supply Fee $90, Child Must Be 3 by 9/30/23

4 Year Old

3-Day (T/WTh) Tuition $298, Supply Fee $90, Child Must Be 4 by 9/30/234-Day (T/WTh/F) Tuition $385, Supply Fee $120, Child Must Be 4 by 9/30/23

Pre-K

5-Day (M/T/WTh/F) Tuition $492, Supply Fee $150, Child Must Be Attending Kindergarten in 2024

Upon Registration, there is a required
non-refundable registration fee of $80.00.

If enrolled, September’s tuition will be due by June 1, 2023, in order to hold your child’s spot. On the first day of School in September 2023, a onetime Supply Fee is due. October 2023 through May 2024, tuition will be due on the 1st of each month.

New students will need to provide a proof of identity and age. This may include a copy of your child’s birth certificate, birth registration or passport.

All new students are required to have a current medical and immunization form turned in before August 1, 2023. Failure to do so may result in the loss of your child’s spot in our school.

Pay the required non-refundable $80 registration fee here. Choose "Miss Pass Through" (not tuition) in the dropdown menu and leave a comment in the memo area.

PHS Registration

I have submitted the $80 non-refundable registration fee.*

Yes!No. Note that your registration is not complete yet

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Signature*

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