25-26 Reenrollment with New Student

Educational Enrollment Contract and Financial Agreement for 2025-2026 Term
Educational Enrollment Contract and Financial Agreement for 2025 - 2026 Term

Educational Enrollment Contract Provisions: This "Educational Enrollment Contract" is made and entered into on the day and date set out below for and in consideration of the mutual promises contained herein and the amounts set forth in the financial provisions included herein, the "Financial Agreement," by and between the parent, guardian, or persons in loco parentis executing this agreement, the "Responsible Party," and Greenwood-Leflore Educational Foundation, Inc., a Mississippi non-profit corporation, the "Educational Corporation," WITNESSETH:

Whenever the male pronoun is used herein, it will be deemed to include the female pronoun or vice versa and, likewise, whenever the singular is used, it will be deemed to include the plural, as the context requires.

Educational Corporation hereby agrees to provide an education under a fully accredited curriculum in accordance with the rules and regulations promulgated by its Board of Directors, the "Board," to the students being enrolled, the "Student," at the grade level listed for the upcoming 2025 - 2026 school year, the "Term."
Student #1*
Grade for 2025-2026 School Year*
Student #2
Grade for 2025-2026 School Year
Student #3
Grade for 2025-2026 School Year
Student #4
Grade for 2025-2026 School Year
Student #5
Grade for 2025-2026 School Year
Student #6
Grade for 2025-2026 School Year
Responsible Party by enrolling Student consents, understands, and agrees that the Student is subject to all the rules and regulations of Educational Corporation as promulgated and established by the Board and/or Pillow Academy Administrators, the "Administration." Further, the Responsible Party agrees to accept and abide by the Student and Athletic Handbooks as now written and later amended. It is specifically understood by the Responsible Party that the rules and regulations provide for a random drug testing / screening process, the "Drug Test," to detect and prevent illegal drug use. Responsible Party consents, understands and agrees to the administering of the Drug Test and releases the Educational Corporation from any resulting liability.

Responsible Party understands, acknowledges and agrees that the Educational Corporation retains the right at any time during the Term of this agreement to terminate this Educational Enrollment Contract and to dismiss the Student from enrollment if, in the discretion of the Administration, such action is warranted. In the event that Student is dismissed from enrollment, the unearned portion of the tuition and fees set out in the dismissed Student's then current Financial Agreement will constitute full liquidated damages in favor of the affected Student and the Responsible Party.

This Educational Enrollment Contract is essential for the Educational Corporation to secure and maintain the necessary faculty and physical facilities required for the education of the Student. The Responsible Party understands and agrees that he is liable for the full amount of the financial obligations contained in the Financial Agreement, including delinquent arrearage, unless released by the Board from any scheduled payments on the remaining balance, and that he will not be eligible for a refund of monthly payments previously paid and deposited. Payments will be retained from May through the month of withdrawal and any pro rata refunds authorized for annual payments will be based on the same criteria of May through the month of withdrawal. Responsible Party consents, understands and agrees that under the rules and regulations of Educational Corporation, Student may be subject to limitations and restrictions if Responsible Party is delinquent in his obligations under the Financial Agreement, up to and including dismissal, and further including but not limited to, a hold on grades and transcripts, restricted access to RenWeb, disqualification or suspension from participating in extracurricular activities and from scheduling testing and exams.

Pillow Academy admits students of any race, color, nationality, or ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, nationality, or ethnic origin in administration of its educational policies, admission policies, and athletic or other school-administered programs.

Financial Agreement Provisions: The Responsible Party promises to pay (waiving presentment, demand, protest and notice of dishonor) to the order of the Educational Corporation the total amount listed below, payable in equal consecutive installments on the same day of each succeeding month unitl paid in full or payable in one single lump sum payment according to the amounts and schedule set forth:

Tuition and Fees 2025-2026
Registration Fee: $225.00

This payment must be submitted with all new family applications. Fee will be waived for all current families that register by February 11, 2025.

Pledge Fee: $240.00

All families must make a fair share pledge of $240.00 per year as long as they have a child enrolled. This can be paid in one lump sum or 12 monthly payments.

Tuition Fee:

2025-2026 Tuition: Plan I - Monthly Payments or Plan II- Payment in Full

Plan I - Payment by the Month

Grade	Tuition amount	Monthy Payment (based on 12 months May 2025-April 2026)
K4 and K5	$5,800.00	$483.33
Grades 1-5	$7,280.00	$606.67
Grades 6-12	$7,335.00	$611.25

Pledge (per family)	Monthly Payment (based on 12 months May 2025-April 2026)
$240.00	$20.00

Plan II - Payment in Full

This is a one-time payment for tuition and pledge amount. A post-dated check dated no later than March 31, 2025, must be included with your registration packet-due to the PA office by February 11, 2025, to avoid a late registration fee. No exceptions. Payment in full after the March 31, 2025 date will not receive the 3% discount on tuition. Discount is not applicable to the $240.00 Pledge Fee which also must be paid in full to receive the discount on tuition.

Grade	Tuition	3% Discount	Balance
K4 and K5	$5,800.00	$174.00	$5,626.00
Grades 1-5	$7,280.00	$218.40	$7,061.60
Grades 6-12	$7,335.00	$220.05	$7,114.95

Pledge - Payment in full (per family)

$240.00

For information on applying for tuition assistance, please contact:

Catherine Fisher cfisher@pak12.com or 662-453-1266.

Total Tuition*
Less Discount (If Paying in Full)
Tuition Payable*
Annual Pledge ($240 per family) *
Registration Fee ($225-Waived for returning families if submitted by 2/11/25)
Total Amount Payable*
WITNESS the signatures of the undersigned to this Educational Enrollment Contract and Financial Agreement on this day of * 2025.
Signature of Responsible Party*

Clear
Printed Name*
Telephone Number*
Parent's Email*
example@example.com
Signature of Responsible Party

Clear
Printed Name
Telephone Number
Parent's Email
example@example.com
Method of Payment

Choose one at time of enrollment.

Complete if Paying in Full
If you are paying in full -type check amount for lump sum payment . Check must be delivered to the High School Office on or before March 31st to receive 3% tuition discount. Students are not enrolled until payment has been received.

Complete if Post Dated Checks
Post Dated Check: Responsible Party Greenwood-Leflore Educational Foundation, Inc. in the amount set forth below to pay and charge his account for monthly checks drawn: Monthly Installments @ $___________
Students are not enrolled until post dated checks have been received in the office.

Complete if Monthly Bank Draft-MUST complete ALL fields if using monthly bank draft
Bank Draft Authorization: Responsible Party authorizes Greenwood-Leflore Educational Foundation, Inc. in the amount set forth below to draw monthly drafts against his bank account per the following account information:
Monthly Draft Installments @ $ ___________
Date of Draft

1st5th10th15th
Name(s) on Account
Checking or Savings

CheckingSavings
Name of Bank
City / State of Bank
ABA Routing Number (9 digits)
Bank Account Number
Authorized Signature on Account (Must sign if drafting)

Clear

New Student Application for Admission

*New Student* - This student is not enrolled at Pillow Academy and has a SIBLING currently enrolled at Pillow Academy.
Student's First Name*
Student's Middle Name*
Student's Last Name*
Application for Grade*
Preferred Name*
Date of Birth*

MonthDayYear
Date
Gender*
Social Security #*
Race*

African-AmericanHispanicAsianCaucasianOther
Student's Mailing Address*

Street Address

CityState / Province

Postal / Zip Code
Student's Cell Phone
Home Phone
Title
Father's First Name*
Father's Last Name*
Father's Phone*
Title
Mother's First Name*
Mother's Last Name*
Mother's Phone*
Emergency Contact NOT at student's home
Name
Emergency Contact relationship to student
Emergency Contact phone number
Please enter a valid phone number.
Name of Present School*
Address*
School Contact*
Phone
Has the applicant ever been expelled, denied re enrollment at a school, or counseled not to return to a school?*
If yes, please explain
Has the applicant ever been the subject of any major school disciplinary action?*
If yes, please explain
Has the applicant ever been the subject of any law enforcement action?*
If yes, please explain

New Siblings at Pillow Academy are required to provide the following documents to the Pillow Academy Office of Admissions.

Students entering K4 or K5	Certified Birth Certificate a certified copy of your child's Birth Certificate to remain at PA as a part of his/her permanent record Copy of Social Security Card Copy of Mississippi Immunization Certificate Pillow Academy Admissions Test (K5)
Students entering 1st-5th Grade	Certified Birth Certificate a certified copy of your child's Birth Certificate to remain at PA as a part of his/her permanent record Copy of Social Security Card Copy of Mississippi Immunization Certificate Most Recent Report Card Copy of latest Achievement Test Scores Disciplinary Report Pillow Academy Admissions Test
Students entering 6th-12th Grade	Certified Birth Certificate a certified copy of your child's Birth Certificate to remain at PA as a part of his/her permanent record Copy of Social Security Card Copy of Mississippi Immunization Certificate Most Recent Report Card Copy of latest Achievement Test Scores Drug Test:All Applicants must complete and pass a drug test screening process prior to acceptance at Pillow Academy. The screening will be at the parents' expense Disciplinary Report Pillow Academy Admissions Test

A siblings is not enrolled with the submission of this application. To be enrolled, all documents, form of payment, and results of admissions test (K5-12th) must be received by the admission's office.
Should be Empty:

Educational Enrollment Contract and Financial Agreement for 2025-2026 Term

Tuition and Fees 2025-2026

Method of Payment

Bank Draft Authorization: Responsible Party authorizes Greenwood-Leflore Educational Foundation, Inc. in the amount set forth below to draw monthly drafts against his bank account per the following account information:

New Student Application for Admission

New Siblings at Pillow Academy are required to provide the following documents to the Pillow Academy Office of Admissions.

A siblings is not enrolled with the submission of this application. To be enrolled, all documents, form of payment, and results of admissions test (K5-12th) must be received by the admission's office.