Brush Creek Montessori School

1569 Brush Creek Road, Santa Rosa, CA 95404, 707 539-7980, Fax 707 539-7549

Elementary Enrollment Form 2008-2009

Student's Name_______________________________
 Home Phone_________________________

Birthdate_____________________________
 M / F (circle one)

Address__________________________________________________________________________

City_______________________________________________Zip____________________________

Parent #1Name _____________________________ Occupation___________________________

Parent #1Work Phone________________________ Cell Phone___________________________

Parent #2Name _____________________________ Occupation___________________________

Parent#2 Work Phone________________________ Cell Phone___________________________


My child will attend:
LOWER ELEMENTARY
(K-3rd)
UPPER ELEMENTARY
(4th-6th)
MIDDLE SCHOOL
(7th-8th)
$7,700 per School Year
$7,850 per School Year
$8,400 per School Year

    Tuition Payable as follows:

     1. 1. At the time of enrollment, a non-refundable deposit fee of $50 must accompany this form. If your child is accepted, this fee will go towards the Registration Fee ($100) and Materials Fee( $400.)
    2. A check for the June/2009 tuition must be submitted when your child is accepted.
    3. 3. The balance of the yearly tuition will be billed in nine monthly installments due each month from September 1, 2008 through May 1, 2009.
    4. A late fee of $50/month will be assessed for any overdue balance.
    5. An option to pay the full-year tuition is available at a 3% discount (Sept. 1, 2008 deadline)
    6. Credit Cards are accepted.
    7. Refunds can only be made if you move from Sonoma County.
    8. A fee of $25 will be assessed returned checks.
    9. Any modification of these terms must be in writing, signed by both parties.

Hours/Materials Contribution (Outlined in the Community Handbook)

(Please initial one of the following choices)

___ Our family would like to participate in 25 Community Service Hours this year

And/Or       

 ___ Our family would like to participate in the BCMS Community Service hours, but would rather contribute $375.00 (tax deductible) towards school maintenance/ development.



I ACCEPT THE ABOVE TERMS.

Parent's/Guardian's Signature: ____________________ Date:____________________

Payment
Check Number
Amount Paid
Registration Fee    
Materials Fee    
Tuition    


Office Signature: ______________________________ Date:____________________