For Office Use Only
Pythagoras Children’s Academy
The Greek Orthodox Church of Saint Demetrios
893 North Church Road • Elmhurst, IL 60126 • 630.834.0477
www.pythagoraschildrensacademy.org
Date Rec’d: _______________
Rec’d by: _________________
Payment Rec’d: $___________
 Cash /  Check #_________
Outstanding Balance ( Y / N )
2017-2018 APPLICATION FOR ADMISSION
2017 Stewardship fulfilled ( Y / N )
Student & Family Information
Student’s Legal Name:
(Last)
Date of Birth:
(First)
Age on Sept. 1st:
(Middle)
Gender:  M F
Grade entering:
Student’s Greek/Baptismal Name:___________________________________ Student’s Feast Day:________________
Has the student been baptized, in water, in the name of the Father, and of the Son, and of the Holy Spirit? (Y / N)
If yes, please specify parish and location:
________________________________________________________________________________
___________
Mother/Guardian Information:
Father/Guardian Information:
Name:
Name:
Address:
Address:
City:
Zip:
City:
Zip:
Home Phone:
Home Phone:
Cell Phone:
Cell Phone:
Work Phone:
Work Phone:
Occupation:
Occupation:
EMAIL:
EMAIL:
Parental Information:
Parents married/living together
Divorced
Student resides with: Both Parents Mother
Separated
Father Deceased/ Mother Deceased (please circle)
Father
Other:
If parents are divorced, legal custody belongs to:
*Custodial parent/guardian must provide copy of Divorce Decree or other appropriate documentation.
Correspondence to be sent to: Both parents
Sibling Information:
Name
Mother
Age
Father
Other:
Current School (if applicable)
Pythagoras Children’s Academy
The Greek Orthodox Church of Saint Demetrios
893 North Church Road • Elmhurst, IL 60126 • 630.834.0477
www.pythagoraschildrensacademy.org
2017-2018 APPLICATION FOR ADMISSION
Student Name: ____________________________________________________ Date of Birth: _____________________
TUITION PRICE
CHECK
PROGRAM
BELOW:
TIMES
*On/Before
3/24/2017
After
3/24/2017
GRADE
DAYS/REQUIREMENT
Fifth Grade
5 days a week
8:30 am – 3:15 pm
$4,500
$4,700
Fourth Grade
5 days a week
8:30 am – 3:15 pm
$4,500
$4,700
Third Grade
5 days a week
8:30 am – 3:15 pm
$4,500
$4,700
Second Grade
5 days a week
8:30 am – 3:15 pm
$4,500
$4,700
First Grade
5 days a week
8:30 am – 3:15 pm
$4,500
$4,700
Kindergarten
(Full-Day)
5 days a week
*Requirements: 5 years of age by 9/1/2017
9:00 am – 3:10 pm
$4,300
$4,500
Pre-Kindergarten
(Full-Day)
5 days a week
*Requirements: 4 years of age by 9/1/2017
9:00 am – 3:05 pm
$4,300
$4,500
M/W/F Pre-Kindergarten
(Full-Day)
3 days a week, Full-Day
*Requirements: 4 years of age by 9/1/2017
9:00 am – 3:05 pm
$4,000
$4,200
M/W/F Preschool
(Full-Day)
3 days a week
*Requirements: 3 years of age by 9/1/2017,
fully potty-trained
9:00 am – 3:05 pm
$4,000
$4,200
M/W/F Preschool
(Half-Day)
3 days a week
*Requirements: 3 years of age by 9/1/2017,
fully potty-trained
9:00 am – 12:00 pm
$3,500
$3,700
T/TH Preschool
(Full-Day)
2 days a week
*Requirements: 3 years of age by 9/1/2017,
fully potty-trained
9:00 am – 3:05 pm
$3,500
$3,700
T/TH Preschool
(Half-Day)
2 days a week
*Requirements: 3 years of age by 9/1/2017,
fully potty-trained
9:00 am – 12:00 pm
$3,000
$3,200
Second Child Discount (deduction taken off youngest child)
10% off tuition only
Third or more Child Discount (deduction taken off youngest child)
20% off tuition only
DISCOUNT REFERRAL- a $200 discount will be applied to your tuition payment for referring a NEW
family to PCA- both parties must be in good standing with the church (form applies)
$200 off tuition only
*EARLY BIRD DISCOUNT: You are eligible for early bird discount if your completed application, application fee, tuition and fees for
2016-2017 are paid in full, and 2017 stewardship commitment are all submitted on or before March 24, 2017 (See prices listed above)
Pythagoras Children’s Academy
The Greek Orthodox Church of Saint Demetrios
893 North Church Road • Elmhurst, IL 60126 • 630.834.0477
www.pythagoraschildrensacademy.org
2017-2018 FEES AND TUITION SCHEDULE
NON-REFUNDABLE APPLICATION FEE (will be applied toward tuition): Per student: Preschool & Pre-K = $150; K – 5th = $300.
SCHOOL SUPPLY FEES payable in full at prior to the first day of school
Full-Time Pre-K – Fifth Grade Students ………………………………………………………………………………...…….. $300
Part-Time Preschool/Pre-K Students………………………………………………………….………………..………………. $250
FUNDRAISING FEES: Payable in full to PPO (per family) prior to the first day of school……………………………………..….
$100
HOT LUNCH FEES (optional): For all students except T/TH & MWF half-day Preschool students, payable in full to PPO (per student)
prior to the first day of school……………..………………………………………..……………………………...………………………… $125
NAP MAT FEE: For all full-day 3 year old Preschool students…………………………………………………………………………. $20
STEWARDSHIP/NON-STEWARDSHIP FEE: A suggested minimum of $500 to be paid in full or ACH monthly commitment at time of
application.
Tuition Payment Options:
A.




B.
TADS: Tuition payments must be made through our online tuition service, TADS. Payment options are as follows:
Payable in full at time of registration (receive a 5% discount off Tuition only).
Payable in 3 equal installments (8/2017, 12/2017, and 2/2018) through TADS (first installment is due on or before orientation).
Payable in 4 equal installments (8/2017, 10/2017, 12/2017, and 2/2018) through TADS (first installment is due on or before
orientation).
Payable in 6 equal installments (8/2017, 10/2017, 11/2017, 12/2017, 1/2018 and 2/2018) through TADS (first installment is
due on or before orientation).
Church Office: Payments paid in full prior to the beginning of the school year may be made by cash or check in the Church
office. Partial payments or payments after the school year commences will not be accepted in the Church office.
John C. Kulis Charitable Foundation Matching Grant Fund
Please consider making a donation to PCA which will be matched dollar-for-dollar by the Kulis Foundation. All proceeds will directly
benefit Pythagoras Children’s Academy. Please select an option if you would like to make a donation:
$100
$250
$500
Other:
$1,000
$1,500
$2,000
$2,500
Not at this time
I, the undersigned parent/guardian, am a current steward of The Greek Orthodox Church of St. Demetrios and do hereby assume
responsibility for the tuition, related fees, and balances for the Pythagoras Children’s Academy for the 2017-2018 school year.
I understand the Application for Admission is considered complete when the application fee, stewardship commitment, and, if
applicable, all tuition and fees for 2016-2017 must be paid in full.
Student Name:
PARENT/GUARDIAN SIGNATURE: