MOUNT SAINT MARY ACADEMY
Sponsored by the Sisters of Mercy
Intent to Return Form – 2017-2018 School Year
Thank you for having your child/children enrolled at Mount Saint Mary Academy
this past year! We hope you choose to return for the 2017-2018 school year.
Enrollment is limited, and we want to ensure that your children have a space
reserved for next year. Please return this form by January 13, 2017!
_____ YES! My child/children will be returning to MSMA next year!
Please print the information below
Student name(s) :
Date of Birth:
Grade entering:
Ethnicity:
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New sibling to MSMA:
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ANY STUDENT ENTERING NURSERY OR PK, PLEASE CIRCLE THE FOLLOWING:
Nursery program
3 day program / 5 day program
Pre-k program
11:45 or 2:15 dismissal
11:45 or 2:15 dismissal
My child will be attending our Aftercare Program on a regular basis yes/no
(please circle one of the above)
_____ No, my child/children will not be returning to MSMA next year.
There are two methods of making tuition, book/supply, activity and fair share
payments. The first is through FACTS, a tuition management program, which
consists of ten payments from your bank account into the MSMA bank account,
beginning in July and ending with April’s payment. The second is one payment for
the full tuition. It is due on July 1, 2017. At this time our option is to use option
#_______ (one or two).
_____ PLEASE BILL THE $200.00 NON REFUNDABLE FAMILY REGISTRATION FEE TO
MY FACTS ACCOUNT IN JANUARY 2017.
_____ ENCLOSED IS A CHECK FOR $200.00 Check #__________
Parent Signature______________________________________ Date___________
Please be advised in the Mount Saint Mary Academy Parent/Student Handbook, it
is the school’s policy that parents must notify the school in writing if a student is
being withdrawn. If a student is withdrawn between the first day of school and
December 20th the family is responsible for ½ of the full tuition. If a student is
withdrawn after January 1st the family is responsible for the full tuition amount.