Registration Form

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Office use only:

Roseville Lutheran Preschool

Registration paid: ____

1215 West Roselawn Avenue, Roseville, MN. 55113 Phone: (651) 488-6887 Fax: (651) 488-4854

Date:______________

Child’s Name

Name to be called

Home address

City

Telephone

Zip Birthday

Boy

Girl

Father’s/Guardian’s Name Home address

City

Zip

Employer’s Name Occupation

Work Phone #

Email

Cell Phone #

Mother’s/Guardian’s Name Home address

City

Zip

Employer’s name Occupation

Work Phone #

Email

Cell Phone #

Parents are: Married_____________ Separated___________ Divorced__________ Other children in the family (names and ages) The Preschool is sponsored by Roseville Lutheran Church and offers a non-denominational, Christian program. All children, regardless of race or creed, are welcome.

I am registering my child for: Class 1 M-W-F

3 year olds

(9:15–11:45 a.m.)

5 Parent days

Class 2 T-Th

3 year olds

(9:15-11:45 a.m.)

3 Parent days

Class 3 M-W-F

4 year olds

(9:15-11:45 a.m.)

5 Parent days

Class 4 T-Th

4 year olds

(9:15-11:45 a.m.)

3 Parent days

Combined class 1&2 3 year olds

(9:15 – 11:45 p.m.)

5 - 8 Parent days

Combined class 3&4 4 year olds

(9:15 – 11:45 p.m.)

5 - 8 Parent days

I understand that parents are required to participate in classroom activities a specified number of days, determined by the class I choose. All children must be of age (3 or 4) and toilet trained by September 1. A registration fee of $50.00 must accompany this application. This fee is not refundable. This fee is not applied towards tuition. Parent Signature

Registration Qualified applicants are accepted for enrollment subject to the following priorities: A. Families that are currently enrolled in a class at Roseville Lutheran Preschool. B. Families who are members of Roseville Lutheran Church or have been enrolled in the Nursery School in the past. C. Priority for (A, B) will not continue after March 1. Registration is open to the public on a first come, first served basis. If no vacancy exists, applicants will be placed on a waiting list. Vacancies will be filled according to the placement on the waiting list. Tuition Tuition for the 2017-2018 year is: 2 day a week class $115.00 a month 3 day a week class $160.00 a month 5 day a week class $210.00 a month A non-refundable refundable fee of $50.00 is due at time of registration. Roseville Lutheran Preschool is a non-profit organization that operates mainly on the tuition fees given by each student. Therefore it is important that your payment is received each month. Method of Payment: 1. Tuition is due on your child’s first day of class each month. 2. During the Preschool Orientation or by the first day of class in September, we will collect the first and last month’s tuition (Sept. and May’s). This will insure us 30 days to find a replacement for the vacancy created in the class in case you find it necessary to withdraw. 3. Tuition is the same whether the month is short or long, and if your child is sick or on vacation. Full tuition should be paid during the school year to insure your child’s continued enrollment. 4. You can pay by check to: Roseville Lutheran Preschool and drop it off in classroom. Or you can pay online through RosevilleLutheran.org (see the Director for details). Limited financial assistance is available. See the Director for an application. If you have any further questions regarding these policies, please contact the Preschool Director at 651-488-6887.

I have read and understand the registration and tuition policies. Signed_______________________________________________________Date__________________