KINGDOM FOUNDATION GLOBAL LLC
STEM Program Application
Family Group Special (2 Kids): $230
Program Location:
1574 Williamson Road, Griffin, Georgia
Program Days:
Tuesdays and Wednesdays
Program Hours:
10:00 AM–2:00 PM
Program Contacts:
Valerie Phillips (770-771-8055) | Sheena Freeman (678-732-4942)
APPLICANT INFORMATION
Parent/Guardian Name:
*
Home Address:
*
City / State / Zip:
*
Email Address:
*
example@example.com
Phone Number:
*
Format: (000) 000-0000.
CHILD INFORMATION
Child(ren)'s Name(s):
*
Days Attending (circle): Tuesday / Wednesday
*
PROGRAM SERVICES
STEM Learning:
Computer Learning:
Homework Assistance:
PROGRAM FEES
Application Fee: $25.00 (non-refundable)
Weekly Program Fee: $125.00
Flat Weekly Fee (if enrolled but absent): $100.00
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Late Pick-Up Fee: $10.00 per 30 minutes (second occurrence: $20.00 per 30 minutes)
PARENT/GUARDIAN AGREEMENT
*
I agree to pay all weekly program fees through approved payment methods, including Cash App ($Kingdomfountain) or Zelle.
I understand that a late payment fee of $10.00 may apply.
I agree to provide at least 24 hours' notice for cancellations. Failure to do so may result in full program charges.
I agree to notify the program coordinator between 1:00 PM and 6:00 PM on the day before if my child will be absent the following day.
I understand that the program includes STEM instruction, computer learning, and enrichment activities.
I understand that if my child is enrolled but does not attend, a $100.00 flat weekly fee will still apply.
SIGNATURES
Parent/Guardian Print Name:
*
Signature:
*
Date:
*
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Month
-
Day
Year
Date
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