Registration Form | Hosanna Lutheran Childhood Center

1 Select Program

2 Child Information

3 Registration Fee

Child Admissions Information
Mother's Name*
First Last
Mother's Email*
Enter Email Confirm Email
Address*
Street Address City State ZIP Code
Mother's Home Phone
Mother's Work Phone
Mother's Cell Phone*
Father's Name
First Last
Father's Email
Enter Email Confirm Email
Address (if different)
Street Address City State ZIP Code
Father's Home Phone
Father's Work Phone
Father's Cell Phone
Name your child is called at home
Name you wish your child to learn to recognize in print and writing
Child lives with
Names and Ages of Siblings
Have any of your other childern attended HLCC?
Has your child attended any structured activities?
Has your child attended any other preschool?
Did a current student refer you to HLCC? If so, who?
What are your goals for your child this school year?*
Are there any family or custody issues that would affect your child attending HLCC? In the case of a divorce or separation, the Center cannot deny a parent access to a child unless legal documentation has been provided to the Center.*

HLCC will strive to enroll your child(ren) in your preferred class, but cannot guarantee such placement. If transportation is an issue and you need to be placed with specific families, please note that preference on the bottom of this form.

Tuition Payments: Tuition is due on the 1st of each month unless other suitable arrangements are made with the HLCC Director. Since HLCC is a non-profit organization, we ask that you please pay on time to help us keep our costs down and still maintain a high-quality early education program. Tuition can be paid online, by check or money order and should be made payable to “HLCC.” If your child is ill, or you choose to not send your child, tuition is still expected on the 1st of that month.

Late Payment: There is a late charge of $25.00 for any payment received after the 5th of the month. If this occurs on a continual basis without satisfactory arrangements being made with the Director, it will be grounds for dismissal. HLCC will collect on delinquent accounts.

Withdrawal Policy: Four weeks advance written notice to the Director is required.

** All Children must be at least three years of age and fully potty trained to attend HLCC.
After submitting the form you will be directed to pay the registration fee via PayPal. A PayPal account is not required, you may pay with a debit or credit card. After completion you will receive a follow-up email detailing your submission.
Registration Fee*
- Registration Fee $50.00
- Registration Fee + $80.00 Enhanced Educational Activity Fee
Registration Fee*
- Registration Fee $50.00
- Registration Fee + $80.00 Enhanced Educational Activity Fee
Registration Fee*
- Registration Fee $50.00
- Registration Fee + $100.00 Enhanced Educational Activity Fee
Registration Fee*
- Registration Fee $50.00
- Registration Fee + $100.00 Enhanced Educational Activity Fee
Total
$0.00
Parent's Signature (Typed)*
First Last
Phone
This field is for validation purposes and should be left unchanged.

Hosanna Lutheran Childhood Center 2019 – 2020 Registration Form

Registration

Hosanna Lutheran Childhood Center
2019 – 2020 Registration Form