FAMILY INFORMATION:
All fields in this section are required

Last Name:
 Father's Name:
 Mother's Name:
Address:
City:
State:
Zip:
Telephone:
Email:
 
Cell Number :
   
Emergency Contact Name:
 Emergency Contact Phone:
 
     

VOLUNTEER ASSIGNMENT:

Each family is required to serve in either one Teaching position or two Volunteer positions such as Assistant Teaching, Cleanup, Nursery, etc. Positions must be pre-approved by Enrollment Coordinator.

Volunteer Position #1:
Volunteer Position #2:

CHILD/CLASS INFORMATION:

   
FINE ARTS
9:00 - 12:00 pm
 
SHARED LEARNING
1:00 - 4:00 pm
Child #1 Name
 Grade
 FA 1st Hr. 9:00
 FA 2nd Hr. 10:00
 FA 3rd Hr. 11:00
   SL 1st Hr. 1:00
 SL 2nd Hr. 2:00
 SL 3rd Hr. 3:00
   
FINE ARTS
9:00 - 12:00 pm
 
SHARED LEARNING
1:00 - 4:00 pm
Child #2 Name
 Grade
 FA 1st Hr. 9:00
 FA 2nd Hr. 10:00
 FA 3rd Hr. 11:00
   SL 1st Hr. 1:00
 SL 2nd Hr. 2:00
 SL 3rd Hr. 3:00
   
FINE ARTS
9:00 - 12:00 pm
 
SHARED LEARNING
1:00 - 4:00 pm
Child #3 Name
 Grade
 FA 1st Hr. 9:00
 FA 2nd Hr. 10:00
 FA 3rd Hr. 11:00
   SL 1st Hr. 1:00
 SL 2nd Hr. 2:00
 SL 3rd Hr. 3:00
   
FINE ARTS
9:00 - 12:00 pm
 
SHARED LEARNING
1:00 - 4:00 pm
Child #4 Name
 Grade
 FA 1st Hr. 9:00
 FA 2nd Hr. 10:00
 FA 3rd Hr. 11:00
   SL 1st Hr. 1:00
 SL 2nd Hr. 2:00
 SL 3rd Hr. 3:00
   
FINE ARTS
9:00 - 12:00 pm
 
SHARED LEARNING
1:00 - 4:00 pm
Child #5 Name
 Grade
 FA 1st Hr. 9:00
 FA 2nd Hr. 10:00
 FA 3rd Hr. 11:00
   SL 1st Hr. 1:00
 SL 2nd Hr. 2:00
 SL 3rd Hr. 3:00
   
FINE ARTS
9:00 - 12:00 pm
 
SHARED LEARNING
1:00 - 4:00 pm
Child #6 Name
 Grade
 FA 1st Hr. 9:00
 FA 2nd Hr. 10:00
 FA 3rd Hr. 11:00
   SL 1st Hr. 1:00
 SL 2nd Hr. 2:00
 SL 3rd Hr. 3:00

LOCATION OF PARENT DURING SHARED LEARNING (For Emergency Purposes)

1st Hour:
 2nd Hour:
 3rd Hour:

ENROLLMENT/CLASS FEES:

Fine Arts Contribution $16.00 per Family*

Class enrollment is accepted on a first- come, first-served basis.  Class Fees Are Non-Refundable.

*Fine Arts Contribution Waived for Teachers & Assistants.  Must Be Pre-Approved by Fine Arts Director.

Shared Learning Contribution $20.00 per Family
Class Fees (if applicable):
Total Amount Due: