OFFICE USE ONLY
Date application received: ____________________________
Application fee: _______________________
Check # _________________________
Application for Enrollment in Preschool Classroom
Please complete this application and return to the school office. Applications will be process on a firstcome first-served basis for this mid-year enrollment. Remaining applications will be placed on a wait list
and contacted when a spot opens up. All fees are non-refundable.
Child’s Name_____________________________________________
Birthdate_____________________________
Child’s Nickname_________________________________________
Child’s Gender M _________ F ________
Parent/Guardian’s Name _________________________________
Email _______________________________
Full Address __________________________________________________________________________________________
1st phone # _______________________________________________
2nd phone # _________________________
Parent/Guardian’s Name __________________________________
Email _______________________________
Full Address (if different) ______________________________________________________________________________
1st phone # ________________________________________________ 2nd phone # _________________________
Are you a returning family? Please list children who have attended and when __________________________
Please enroll my child:
o 2 ams or pms per week $355/mo
o 3 ams or pms per week $480/mo
o 4 morns per week $630/mo
o 5 morns per week $750/mo
o 2 full days per week $620/mo
o 3 full days per week $855/mo
If not attending 5 days per week, are you flexible on the days you send your child? _____________________
In order of preference, what days would you like your child to attend? _________________________________
In order of preference, are there days when your child cannot attend? ________________________________
Please return this application with a check for $180 made payable to St. Timothy’s Preschool. If your child
is accepted, then we will send you confirmation, along with paperwork to be completed. Your last
month’s tuition (see fees above) is due along with your first month’s tuition by your child’s first day of
school. These payments will hold your child’s spot in the classroom. Failure to pay these fees may forfeit
your spot in the classroom. All fees are non-refundable.
I have read the above information and I agree with these policies.
Parent/Guardian Name _______________________________________
Date _______________________________
Parent/Guardian Signature ___________________________________________________________________________
Return application and fees to:
St. Timothy’s Preschool
Attn.: Fall Enrollment
2094 Grant Road
Mtn View CA 94040
Please make checks payable to St. Timothy’s Preschool
St. Timothy’s Preschool does not discriminate in its educational programs, activities, or employment practices with respect to ethnic
group, religion, gender, color, race, national origin or physical or mental ability.
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