Registration Form

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	Country

Phone Number *

Area Code Phone Number

E-mail *

Church Affiliation / Home Church:

Referred by:

Class Signup:

Students must be the age of the class (2, 3, 4 for PreK 1 & 4 1/2 for PreK 2) before September 1st.

2 Year Old Classes

2 Day AM - Mon / Wed (9:00am - 11:30am) $110/mo 2 Day AM - Tue / Thur (9:00am - 11:30am) $110/mo No Preference on class schedule

3 Year Old Classes

3 Day AM - Mon/Wed/Thur (9:00am - 11:30am) $120/mo 3 Day AM - Mon/Wed/Thur (9:00am - 11:30am) plus Friday Enrichment ALL Day $190/mo 3 Day PM - Mon/Wed/Thur (12:15pm - 2:45pm) $120/mo 3 Day PM - Mon/Wed/Thur (12:15pm - 2:45pm) plus Friday Enrichment ALL Day $190/mo 3 Day AM - Mon/Wed/Fri (9:00am - 11:30am) $120/mo 3 Day ALL Day - Mon/Wed/Fri (9:00am - 2:45pm) $265/mo No Preference on 1/2 Day Schedule

PreK 1 - 3day Classes

3 Day AM - Mon/Wed/Thur (9:00am - 11:30am) $120/mo 3 Day AM - Mon/Wed/Thur (9:00am - 11:30am) plus Friday Enrichment ALL Day $190/mo 3 Day ALL Day - Mon/Wed/Thur (9:00am - 2:45pm) $250/mo 3 Day ALL Day - Mon/Wed/Thur (9:00am - 2:45pm) plus Friday Enrichment ALL Day $285/mo

PreK 1 - 4day Classes

4 Day AM - Mon/Tue/Wed/Thur (9:00am - 11:30am) $140/mo 4 Day AM - Mon/Tue/Wed/Thur (9:00am - 11:30am) plus Friday Enrichment ALL Day $210/mo 4 Day PM - Mon/Tue/Wed/Thur (12:15pm - 2:45pm) $140/mo 4 Day PM - Mon/Tue/Wed/Thur (12:15pm - 2:45pm) plus Friday Enrichment ALL Day $210/mo 4 Day ALL Day - Mon/Tue/Wed/Thur (9:00am - 2:45pm) $285/mo 4 Day ALL Day - Mon/Wed/Thur (9:00am - 2:45pm) plus Friday Enrichment ALL Day $355/mo No Preference on 1/2 Day Schedule

PreK 2 - 4day Classes

4 Day ALL Day - Mon/Tue/Wed/Thur (9:00am - 2:45pm) $295/mo 4 Day ALL Day - Mon/Tue/Wed/Thur (9:00am - 2:45pm) plus Friday Enrichment ALL Day $365/mo

1/2 day classes have a one-time Workbook fee of $50 due in August.
Full Day classes have a one-time Workbook & Materials fee of $75 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.

Registration fee for 2020/2021 is $50.00

*You may pay the Registration 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 $3.00.

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

By pressing "Submit Form", you are stating that you understand that the $50 registration fee is non-refundable, and is needed to secure your child's place on the enrollment list.

Registration Fee

Mail Payment (1500 Lower Huntington Road, Fort Wayne, IN 46819) Drop Off Payment (1500 Lower Huntington Road, Fort Wayne, IN 46819)

Online Payment ( includes transaction fee) $ 53.00

REGISTRATION FORM 2020/21