Toddler Program Statement of Account


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PRE-TODDLER & TODDLER PROGRAM STATEMENT OF ACCOUNT

CHILD'S SURNAME _______________________ CHILD'S NAME ____________________ ADDRESS _________________________________ BIRTH DATE______________ (m/d/y) CITY ______________________________________ PHONE (_______) _______________ POSTAL CODE __________________ CAMPUS _________________________________ COMMENCING DATE: ___________________ CLASS:_____________________
Pre-Toddler Program: 4 Half Days Per Week - $520.00 Monthly				$______________
5 Half Days Per Week - $610.00 Monthly 3 Full Days Per Week - $642.00 Monthly				$______________
4 Full Days Per Week - $768.00 Monthly				$______________
5 Full Days Per Week - $910.00 Monthly				$______________
Toddler Program: 3 Half Days Per Week - $438.00 Monthly				$______________
4 Half Days Per Week - $504.00 Monthly				$______________
5 Half Days Per Week - $590.00 Monthly				$______________
3 Full Days Per Week - $630.00 Monthly				$______________
4 Full Days Per Week - $752.00 Monthly				$______________
5 Full Days Per Week - $890.00 Monthly				$______________
SPECIFIC DAYS: _______________________________ TIMES _______________________

LESS 8% DISCOUNT (FULL PAYMENT FOR 2^nd & 3^rd SIBLING)				$______________

TOTAL MONTHLY FEE:				$______________
FOR OFFICE USE ONLY DO NOT WRITE BELOW THIS LINE
REGISTRATION FEE: _______________			______	$100.00__________
PAYMENT DATES

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__________________ __________ 20_____ ______ $______________

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.

FOR OFFICE USE ONLY DO NOT WRITE BELOW THIS LINE