Enrollment Form 2022/23

Date

Month / Day / Year

Gender *

Boy Girl

Student Name *

First Name Last Name

Birth Date *

Month Day Year

Age (as of Sept 1) *

Guardian Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State

Zip Code

Home Phone Number *

Area Code Phone Number

Cell Number *

Area Code Phone Number

E-mail *

Church Affiliation / Home Church:

Referred by:

Parent Name

Student Name

Class Signup:

Age Requirements for each class is September 1st.

2 & 3 year olds do NOT need to be toilet trained to attend our classes.

4 & 5 year olds Must be toilet trained to attend our classes.

2 Year Old Program (Must be 2 by September 1st)

AM Class - Mon/Wed (9am - 11:30am) - $120/month AM Class - Tue/Thu (9am - 11:30am) - $120/month

3 Year Old - 3day Program (Must be 3 by September 1st)

AM Class - Mon/Wed/Thu (9am - 11:30am) - $130/month

PreK 1 - 3day Program (Must be 4 by September 1st)

AM Class - Mon/Wed/Thu (9am - 11:30am) - $130/month

PreK 1 - 4day Program (Must be 4 by September 1st)

AM Class - Mon/Tue/Wed/Thu (9am - 11:30am) - $150/month

PreK 2 - 4day Program (Must be 4 1/2 by September 1st)

ALL DAY Class - Mon/Tue/Wed/Thu (9am - 2:45pm) - $305/month

WAITING LIST - CLASSES CURRENTLY FULL (DO NOT PAY FEE)

3 yr old AM Class - 3 day Program Mon/Wed/Thu (9am - 11:30am) - $130/month 3 yr old ALL DAY Class - 3 day Program Mon/Wed/Thu (9am - 2:45pm) - $275/month PreK 1 - 3day Program AM Class Mon/Wed/Thu (9am - 11:30am) - $130/month PreK 1 - 4day Program AM Class Mon/Tue/Wed/Thu (9am - 11:30am) - $150/month PreK 1 - 3day Program ALL DAY Class Mon/Wed/Thu (9am - 2:45pm) - $260/month PreK 1 - 4day Program ALL DAY Class Mon/Tue/Wed/Thu (9am - 2:45pm) - $295/month

1/2 day classes have a one-time Workbook fee of $55 due in August.
Full Day classes have a one-time Workbook & Materials fee of $80 due in August.

*Tuition is based on an annual fee and broken down into nine (9) monthly payments for your convenience. First month's tuition is due by August 30th. All other payments are due by the end of each month, the last payment being the end of April. All accounts must be paid in full by April 30th in order to attend the last month of school and graduation.

Enrollment fee for 2022/2023 is $60.00

*You may pay the Enrollment Fee by mailing it to us, dropping it off in our church office or preschool office, or online payment via paypal. If you choose to pay online there is a transaction fee of $4.00.

Mailing Address is: 1500 Lower Huntington Road, Fort Wayne, IN 46819

By pressing "Submit Form", you are stating that you understand that the $60 enrollment fee is non-refundable, and is needed to secure your child's place on the enrollment list.

Enrollment Fee *

Mail Payment (1500 Lower Huntington Road, Fort Wayne, IN 46819) Drop Off Payment (1500 Lower Huntington Road, Fort Wayne, IN 46819) Online Payment (PayPal - select option below)

PayPal Payment Selection

Enrollment Fee (includes transaction fee) $ 64.00

Submitting the enrollment fee will secure a place on the enrollment list.

Book Fee - 1/2 Day Class (optional now - due in August) $ 55.00

Book Fee can be included but is optional until August.

Book Fee - Full Day Class (optional now - due in August) $ 80.00

Book Fee can be included but is optional until August.

Total $ 0.00

ENROLLMENT FORM 2022/23