NORTHMINSTER COMMUNITY PRESCHOOL

APPLICATION FOR ENROLLMENT

SCHOOL YEAR 2012-2013

CHILD’S NAME:_______________________________________________________________

PARENTS’ NAME:_____________________________________________________________

ADDRESS:_______________________________________________ZIP CODE:___________

TELEPHONE NUMBER:_______________________CHILD’S BIRTHDATE______________

3/4 CLASS: For children who will be three years old by August 1, 2012.**

_________AM Class    Tuesday and Thursday       9:15-11:30                     $98.00 per month

4/5 CLASS: For children who will be four years old by August 1, 2012.**

_________ AM Class    Tues., Wed. and Thurs.      9:15-11:30                    $147.00 per month

** Preschool age requirements are based on Indiana state enrollment guidelines for kindergarten.  Exceptions will be made on an individual basis if parents intend to enroll their child in a kindergarten program that has already established a different kindergarten age requirement.

All children must be completely toilet trained before they can enter the Preschool program in September.

An $90.00 non-refundable registration fee must accompany this application.  This fee will include registration, equipment fee assessment, resource fee, all field trips and a tote bag for each child.  Make checks payable to Northminster Community Preschool.

Return this form with registration check to the Director beginning Tuesday, January 24, 2012 for in-house registration.  Community registration begins Tuesday, January 31, 2012.

______________________________________________________________________________

Parent’s Signature                                                                                                       Date                                                   

Return registration form and payment to:     Northminster Community Preschool

1660 Kessler Blvd., East Drive

Indianapolis, IN 46220

ATTN: Angie Kubacki, Director

251-9489

Visit our website at www.northminsterpreschool.org