For Office Use Only:

 

Date ­­­­­­­­_________________

 

 No. _________________
 

 

□     Male

 

□     Female
 
                                               St. Andrew Lutheran Preschool

     □□□□                                              14640 Soucy Place

                                                         Centreville  VA  20120

                                                               (703)  266-7744

                                                         preschool@st.andrewlc.org

 

 

                                                 APPLICATION  FOR  ADMISSION 

 

 

Child’s Name ________________________________________   Child’s Birth Date ________________________

                                                                                                                                                  (MM/DD/YYYY)

Father’s Name________________________________  Mother’s Name___________________________________

           

Address________________________________________________________________________________

                                       (House/Apt. No.)               (Street)

 

                         _________________________________________________________________________________

                         (City)                                                      (State)                                           (Zip)

 

                         _________________________________________________________________________________

                                 Subdivision                                                     Home Telephone No.

 

 

Father’s Work/Cell Phone ________________

 

Father’s Occupation_____________________
 

 

Mother’s Work/Cell Phone ________________

 

Mother’s Occupation_____________________

 
 
 

 

 

 

 

 

 


Family e-mail address__________________________________________________________________________

           

      I agree that the information provided above may be included in class directories to be published in September 2008 and distributed to Preschool families.

 

 

______________________________________________________________________________________________

                         (Signature)                                                                             (Date)

 

Children must be toilet trained before they enter preschool (no pull-ups, please).   PLEASE RANK YOUR CLASS CHOICE IN YOUR CHILD’S AGE GROUP IN ORDER OF PREFERENCE using the numeral 1 for the first choice, numeral 2 for second choice, etc.

 

3 Yr. Old Classes:     __________       Tuesday/Thursday (2 days/wk.)    $175/month     9:00am – 12:00 noon

    (3 yrs. by 9-30-08)  __________       Wednesday/Friday (2 days/wk.)   $175/month      9:00am – 12:00 noon

                                 __________       Tues/Wed/Fri  (3 days/wk.)          $215/month     9:00am – 12:00 noon

 

4 Yr. Old Classes      __________       Mon/Tues/Thursday                     $215/month      9:00am – 12:00 noon

     (4 yrs. by 9-30-08) __________       Mon/Wed/Friday                          $215/month      9:00am – 12:00 noon

                                 __________       Tues/Wed/Friday afternoon         $215/month      12:30pm – 3:30pm

 

Pre-K Class               __________       Tues through  Friday afternoons $285/month      12:30pm – 3:30pm

      (5 yrs. by 1-31-09)

 

REGISTRATION  CONFIRMATION AND FEES

 

  1. In-House registration must be accompanied by an $90 check to St. Andrew Lutheran Preschool.  Please check all of the categories that pertain to your eligibility for In-House Registration.  Placement in classes will be on a first-come-first-served basis within each of the categories below, beginning with current students.

 

□     Current student re-enrolling

□     Sibling of current student (name of student_______________________)

□     Member of St. Andrew congregation

□     Sibling of alumni (name of student and yr.______________________)

 

  1. Community registration fees will be due upon acceptance to the program.  Your child’s placement in our program  will be confirmed by a letter at which time you will be asked to send in your $90 registration check, due by  Friday, February 15.   (Your child’s placement on our waiting list will also be confirmed by letter.)
  2. ALL  REGISTRATION  FEES  ARE  NON-REFUNDABLE.