Application Form

SMaRT FUN Learning Adventures

Student Registration

Registration for the 2010 fall semester is $25.00 per student. Register before Aug. 30 for only $15! 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 and kindergarten.

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 $1,080       Kindergarten $2,000   

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 $30______  Monthly plan $105_____   Semester plan $500______    

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

                               for 36 weeks            for 10 months: Sept - June       (for total of 2 payments)

____Kindergarten  Payment method desired: Monthly plan $200_____  Semester plan $950_____     Payment in full $1800 ____

                           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)

Signature: ______________________________________________ Date: __________________

                    (mother/guardian)

Signature: ______________________________________________ Date: __________________

                      (father/guardian)