1 - Student Application Form 25-26

Student Application Form

For preschool students entering in the 2025-2026 school year
Date*

MonthDayYear
Date
Student Information
Student Name*

First NameMiddle NameLast Name
{studentName:first}'s date of birth*

MonthDayYear
Date
{studentName:first}'s gender*

MaleFemale
Grade {studentName:first} will be entering:*
Does {studentName:first} have any family members that are currently enrolled in or are currently applying to Turning Point?*

YesNo
Who?*
Does {studentName:first} have any immediate family members who have previously attended Turning Point's VPK program?*

YesNo
Who?*
TPCA can not accommodate all requests, but we try to group friends together as much as possible. Do you know of any friends that you know may be at Turning Point that you would like for us to consider placing with your child?*

YesNo
Who?*

Family Contact Information
Parent/Guardian 1*

PrefixFirst NameLast Name
{parentguardian1:first}'s email*
example@example.com
{parentguardian1:first}'s phone number*
Please enter a valid phone number.
{parentguardian1:first}'s Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Would you like to add another Parent/Guardian?*

YesNo
Parent/Guardian 2*

PrefixFirst NameLast Name
{parentguardian2:first}'s email*
example@example.com
{parentguardian2:first}'s phone number*
Please enter a valid phone number.
Does {parentguardian2:first} live at the same address as {parentguardian1:first}?*

YesNo
{parentguardian2:first}'s address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does {studentName:first} primarily live Parent/Guardian 1 ({parentguardian1:first}) or Parent/Guardian 2 ({parentguardian2:first})?*

Parent/Guardian 1Parent/Guardian 2

VPK Contract Information

2025/2026
Program Options*

Only the VPK Hours (9:00am - noon)VPK + Extended Care
Registration Fee*

I understand that TPCA has non-refundable $100 registration fee. This fee will be paid as the last step in the enrollment process.
Extended Care Options (Select all that apply)*

Early Care (7:00am-8:45am) - $35 per weekAfter Care Option 1 (12:00pm-3:00pm) - $95 per weekAfter Care Option 2 (12:00pm-6:00pm) - $130 per week
Drop In Care*

I understand that a drop-in fee of $7.25 per hour will be charged for hours outside the VPK class time when my child is under TPCA's care during regular operating hours and with additional fees for late pickup beyond the normal extended care hours (7:00am-6:00pm).
The VPK program is a weekly program that follows the TPCA calendar. Additional fees are required if care is used on non-VPK days. All early/extended fees are billed via email. Due dates are listed in the bill. There is no reduction of fees for holidays or when a child is sick, absent, or on vacation from preschool for any reason. Students are not required to pay early/extended care fees for Christmas or Spring break unless the child uses services.

A late fee of $10.00- for every 5 minutes (or any part thereof) will be charged for students picked up after 6:00pm. Three late pick-ups will result in dismissal from TPCA.

A multi-student discount is available.
Financial Agreement
- I am the parent/legal guardian of {studentName:first} {studentName:last}.
- I understand that my tuition payment is due on the date scheduled in the financial contract that I am required to setup in during the enrollment process of admissions.
- I understand that tuition must be paid whether {studentName:first} is in attendance or not.
- I understand that there is no refund or reduction of fees due to absences, illness, vacations, holidays, withdrawal, or closing due to conditions beyond the control of TPCA.
- I understand that I must pay tuition year-round (August to May) according to my payment plan, including holiday breaks, whether or not my child is in attendance.
- I understand that there will be a $30.00 charge on all returned checks. After two returned checks, all future tuition must be paid in cash. All delinquent accounts are cause for immediate dismissal from TPCA.
- If tuition is not paid, I understand my child will be dismissed from TPCA.
- I understand that if I choose to withdraw my child, written notice must be provided to the Director at least two weeks in advance.
By signing this, I affirm that I understand and agree to the terms established in the financial agreement. *

Powered by Jotform SignClear
Signed by*
{date}

Medical Information
Name of Physican or Physician's Office*
Phone number of {physician}*
Please enter a valid phone number.
Does {studentName:first} have any physical limitations (ex: Asthma, etc) or allergies?*

YesNo
Please describe the limitations, severity, and treatment: *
Does {studentName:first} have any learning or developmental needs?*

YesNo
Please describe the learning or developmental need: *
Should be Empty:

Student Application Form

Student Information

Family Contact Information

3 Year Olds Contract Information

VPK Contract Information

Medical Information