Application Form

SMaRT FUN Learning Adventures

Student Registration

Registration for the 2011 fall semester is $50.00 per student. Register before Aug. 30 for only $40! Registration payments are nonrefundable. Admissions to SMaRT FUN Learning Adventures are ongoing throughout the year as space is available. We are currently open as a kindergarten prep program (Pre-K) for ages 4 and 5, Kindergarten, and Grade 1.

Today's Date:_______________                                                 Grade of Student:_____________     

Student's Name:  _____________________________________     DOB:___________________ M  or   F

Student's Name:  _____________________________________     DOB:___________________ M  or   F

Student's Name:  _____________________________________     DOB:___________________ M  or   F

Mother/Guardian: __________________________________________________________________

       Employer: ____________________________  Wk Ph: _________________________

  Mailing Address: ____________________________________________________________

 Mother Home Ph: ______________________   Cell Ph:_________________________

 Email: ________________________________________________________________

Father/Guardian: __________________________________________________________________

 Employer: ____________________________  Wk Ph: _________________________

 Mailing Address: _____________________________________________________________

 Father Home Ph: ______________________   Cell Ph:_________________________

 Email: _______________________________________________________________

If you are divorced, please supply a copy of the divorce judgment.

If you are a non-parental guardian, please supply a copy of the court order.

Yearly tuitions are:  Pre-K $1,225       Kindergarten $2,000        Grade 1 $2,500  

You may break it down in payments as follows - discounts applied on some payment plans:

Select program and payment method desired:

____Pre-K           Payment method desired:  Weekly plan $35______  Monthly plan $120_____   Semester plan $575______    

                                                                                             Due each Monday morning      Due the first of each month           Due by the beginning of each semester

                                                                                             for 35 weeks                             for 10 months: Sept - June           (for total of 2 payments)

____Kindergarten  Payment method desired: Monthly plan $200_____  Semester plan $975_____     Payment in full $1950 ____

                                                                Due the first of each month          Due beginning of each semester      Due on or by the first day of school

                                                                                                                                                        for 10 months: Sept - June                 (for total of 2 payments)

_____Grade 1      Payment method desired: Monthly plan $250____ Semester plan $1,200_____ Payment in full $2,400____

Signature: ______________________________________________ Date: __________________

                    (mother/guardian)

Signature: ______________________________________________ Date: __________________

                      (father/guardian)