Pinnacle Presbyterian Church: Pinnacle Preschool Online Registration

http://www.pinnaclepres.com/PinnaclePreschool/onlineregistration.html

Pinnacle Presbyterian Preschool Online Registration Application

Register for 2012-13 Current School Year Only

Priority registrants are those families whose child is a returning student, sibling of previous student or a church member of six months or more.

Priority: (Please select one of the following, if applicable)
Returning Student \| Sibling of Current or Former Student (If yes, name: ) \| Church Member


Child's Last Name: *	First Name: *
Address: *	City: *	Zip: *
Child's Birth Date: *	Age as of Sept. 1, 2012: *	Gender: *
School District currently residing in: *	Previous School Attended:	Year Attended:


Parent/Guardian Last Name:	First Name:
Telephone:	Cell Phone:
E-mail Address:
Work Phone:	Work E-mail:
Employer:	Occupation:


Parent/Guardian Last Name:	First Name:
Telephone:	Cell Phone:
E-mail Address:
Work Phone:	Work E-mail:
Employer:	Occupation:

Other Children in the Family
Child's Name:	Age:	Gender:	School Attending:
Child's Name:	Age:	Gender:	School Attending:
Child's Name:	Age:	Gender:	School Attending:
Child's Name:	Age:	Gender:	School Attending:

Please indicate first, second or third choice. We attempt to accommodate as many first requests as possible. Child placement decisions are made by the Director and teachers based on the best interest of each child. Both educational and social needs are considered during placement. Other factors included are gender, age, experience in school and personality.

Session applying for: *
(Select your first, second or third choices)

Mini 3-year-olds
(Turns 3 between 9/1-12/31)
Class time: 9 a.m.-Noon

Monday/Wednesday
1st Choice
2nd Choice

Tuesday/Thursday
1st Choice
2nd Choice

3-year-olds
(Turns 3 prior to 9/1)
Class time: 9 a.m.-Noon

2 days
1st Choice
2nd Choice

3 days
1st Choice
2nd Choice

Desert Buddies
(Turns 3 between 9/1)
Class time: 9 a.m.-Noon

Friday Class

4- and 5-year-olds
(Turns 4 prior to 9/1)
Class time: 9 a.m.-12:30 p.m.

A non–refundable registration fee of $250 is due March 1, 2012. A Tuition Payment Agreement along with a Materials & AZ Licensing fees of $75 plus a non–refundable one month’s tuition payment is due on June 1, 2012. If a child is withdrawn after the school year begins, there will be no refunds of any tuition unless the administration is successful in replacing the student. If tuition is refunded, it will be on a prorated basis.

Your name: *

Your e-mail address: *

Parental Comments
Does your child have any health concerns that would limit their participation at school?

Are there any concerns, learning needs or requiprements of which you would like us to be aware of?

List the languages other than English that are spoken at home:

How did you learn about Pinnacle Presbyterian Preschool?

Have you attended a tour of Pinnacle Presbyterian Preschool, if so when?

* Required field

| The preschool office administrator will contact you regarding placement options.