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SCHOOL YEAR FROM SEPTEMBER, 2003 TO JUNE, 2004
CHILD'S SURNAME: _______________________ CHILD'S NAME: ________________________
ADDRESS: _______________________________ DATE OF BIRTH: (M/D/Y) _______________
CITY: _______________________________________ TELEPHONE: (______)______________
POSTAL CODE: __________________
LOCATION: ____________________
COMMENCING DATE: ________________________ CLASS:
______________________________
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Please indicate session ( x ) and amount, and place
amount in "Total" Column |
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Casa |
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Elementary/Renaissance |
Total |
| Times |
A.M._______ |
P.M._______ |
FULL_____ |
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| 5 Days* |
( ) $_______ |
( ) $_______ |
( ) $_______ |
( ) $_______ |
1st Child $_____________ |
| 4 Days* |
( ) $_______ |
( ) $_______ |
( ) $_______ |
( ) $_______ |
2nd Child $_____________ |
| 3 Days* |
( ) $_______ |
( ) $_______ |
( ) $_______ |
( ) $_______ |
3rd Child $_____________ |
* Not available at 415 Toynevale Rd., Pickering or 56 Old Kingston Rd., Ajax.
| * Specific Days:__________________________ |
* Times: ___________________ |
$__________________ |
| 5 DAY EXTRA SUPERVISION: Times a.m. |
_______________ p.m. |
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| Sub-Total |
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$__________________ |
| 10% SIBLING DISCOUNT: |
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$__________________ |
| TOTAL FEES |
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$__________________ |
Please Read Statement of Account Thoroughly.
THIS FORM MUST BE RETURNED TO THE SCHOOL
Fill in all Fields and Attach Statement of Account for Blaisdale Administration.
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