25/26 A Child's Place - 10 Month Application Current Student

2025-2026 A Child's Place

10 Month Application

TWOS, THREES AND FOURS

Current Student
Child's Name

First NameLast Name
Date of Birth*

MonthDayYear
Date
Today's Date*

MonthDayYear
Date
Status of Applicant

Currently enrolled child(ren) - Due October 14, 2024
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Contact/Guardian

First NameLast Name
Primary Contact/Guardian Relationship to Child
Primary Contact/Guardian Phone
Primary Contact/Guardian Phone Type
Primary Contact/Guardian Email
example@example.com
Secondary Contact/Guardian

First NameLast Name
Secondary Contact/Guardian Relationship to Child
Secondary Contact/Guardian Phone
Secondary Contact/Guardian Phone Type
Secondary Contact/Guardian Email
example@example.com
Program Interested in:

Twos Program - 2 years by 9/1/25 (birthday range: 9/1/22 - 8/31/23)Threes Program - 3 years by 9/1/25 (birthday range: 9/1/21 - 8/31/22)Fours Program - 4 years by 9/1/25 (birthday range: 9/1/20 - 8/31/21)
TWOS MON - FRI (9:00 - 12:30) $16,845 per year**
Please indicate First, Second or Third Choice
TWOS MON/WED/FRI (9:00 - 12:30) $9,770 per year**
Please indicate First, Second or Third Choice
TWOS TUES/THURS (9:00 - 12:30) $7,075 per year**
Please indicate First, Second or Third Choice
TWOS EXTENDED PLAY (12:30 - 1:30) $516.60 per day/per year**

EXTENDED PLAY - 12:30 - 1:30 PM
TWOS EXTENDED DAY SCHEDULE OPTIONS

MondaysTuesdaysWednesdaysThursdaysFridays
** 2024-2025 Tuition Charges
THREES MON/WED/FRI (8:45 - 1:00) $8,400 per year**
Please indicate First or Second Choice
THREES MON - FRI (8:45 - 1:00) $12,050 per year**
Please indicate First or Second Choice
THREES EXTENDED PLAY (1:00 - 2:00) $616.00 per day/per year**

EXTENDED PLAY - 1:00 - 2:00 PM
THREES' EXTENDED DAY SCHEDULE OPTIONS

MondaysTuesdaysWednesdaysThursdaysFridays
** 2024-2025 Tuition Charges
FOURS MONDAY - FRIDAY - 4 years by 9/1/23 (8:45 - 1:30) $13,000 per year**

FIVE MORNINGS (8:45 - 1:30)
FOURS EXTENDED PLAY (1:30 - 3:15 PM) $738 per day/per year**

EXTENDED PLAY - 1:30 - 3:15 PM
FOURS EXTENDED DAY SCHEDULE OPTIONS

MondaysTuesdaysWednesdaysThursdaysFridays
** 2024-2025 Tuition Charges
Signed*

Clear
A NON-REFUNDABLE FEE OF $50 MUST BE RECEIVED FOR THIS APPLICATION TO BE PROCESSED. Payment can be made by check to A Child's Place or online at

https://securepayment.link/achildsplace/.
Date*

MonthDayYear
Date
Should be Empty:

** 2024-2025 Tuition Charges

** 2024-2025 Tuition Charges

** 2024-2025 Tuition Charges