Child Information Last Name * First Name * Middle Initial Birth Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023 Gender * - Select -MaleFemale Home Phone * Mailing Address Street * City * State * Zip * Parent/Guardian Information Parent/Guardian’s Name * Parent/Guardian’s Occupation * Work Phone * Cell Phone * E-mail Address * Parent/Guardian’s Name Parent/Guardian’s Occupation Work Phone Cell Phone E-mail Address How did you hear about Bannockburn Nursery School? * Has your child ever been in a school or day care program before? * - Select -YesNo If yes, which one? Briefly indicate why you are changing programs. In order to plan for the most successful school experience for your child, the staff needs to know if your child has been treated for, or you suspect, that your child has any special emotional, physical, or behavioral needs. Examples include, but are not limited to attention deficit, sensory integration problems, severe allergies, impaired senses, and physical limitations. Please specify here any that apply to your child whether they have been diagnosed by a professional or not (use back of application if additional space is needed). Special Needs * Class Placement Request Please indicate your class preference. In the event your preference cannot be accommodated, a school representative will contact you to discuss alternate class placement where possible. Child Placement * Sprouts, 2-&3-year olds – (Age 2 by Sept. 1) Saplings, 3- & 4-year olds – (Age 3 by Sept. 1) Mighty Oaks, 4- & 5-year olds – (Age 4 by Sept. 1) Fee Structure Our tuition fees include the daily cleaning of the school, funding for our financial aid program, on-premises activities sponsored during the school day, and a fee to the Bannockburn Community Club who oversees the management of the building and school grounds. (See www.bannockburncommunity.org for associated benefits for your family). In addition to the $60 new student application fee due at the time of application, a $500 tuition deposit is due within two weeks of the date on the acceptance letter to secure your child’s place in the designated class. The remaining tuition is paid (unless alternative arrangements are made) in four installments. For illustration purposes, the tuition schedule for the 2018/19 school year is shown below. Class 2 day Sprouts 3 day Sprouts 4 day Sprouts 5 day Sprouts Saplings Mighty Oaks Annual Tuition and Fees for* Regular Co-Op $2,577 $3,203 $4,191 $5,116 $4,286 $4,286 Annual Tuition and Fees for* Limited Co-Op $4,000 $5,010 $6,013 $7,432 $6,756 $6,756 * Annual tuition rates include the $500 deposit paid upon acceptance. Limited Co-op Option Each year a very small number of limited co-op positions are available for a higher tuition. Limited co-op parents or guardians are only required to co-op 2 times in a 6-week period and are never scheduled as substitutes. Limited co-op families must fulfill all other school related responsibilities (listed on page 3). You may also contact the Membership Chair for more information about the limited co-op option. Limited Co-op Option I would like to request a Limited Co-op position. Priorities for Acceptance Applications received by DECEMBER 1st, which meet any of the following criteria (listed in order of priority), are given preferential consideration for admission to the school or the wait list. Please check any of the following that apply to your child: Priorities for Acceptance Members applying for a child who is already enrolled and children of BNS employees. Family applying for a child who will be attending concurrently with a sibling who is already enrolled. Family who has had children previously enrolled in the school. Family currently resides within the Bannockburn community or the Bannockburn Elementary School district. Parents/Guardians who attended BNS as children. List years attended: Refund Policy If I withdraw my child by March 1st, the $500 deposit will be refunded. After March 1st any deposit and/or tuition is forfeited. If I voluntarily decide to withdraw my child from the School after the commencement of the school year I must provide the School with notice of the intention to withdraw at least four (4) weeks before my child’s departure. Such notice shall be provided in writing to the President of the Board of Directors. All pre-paid tuition and fees will be forfeited and I will remain responsible for payment of all tuition and related fees until the vacancy caused by my child’s departure is filled or until the end of the school year, whichever occurs first. Voluntary departure shall not include any withdrawal that occurs based on a mutual agreement between School staff and/or the Board of Directors that the child’s continued enrollment in the School is not in the best interest of the child, the family, and/or the School, nor shall the term include withdrawals pursuant to Section XII of the bylaws. (A copy of the by-laws is available from the School Office). Parental Responsibilities to Bannockburn Nursery School BNS is a parent -participation nursery school that counts on the active involvement of its members to ensure its ongoing operation. Therefore, all parents or guardians of students enrolled in BNS must agree to the following: Co-oping Responsibilities Co-op in the classrooms on a rotating schedule – either as a “regular” or “limited” co-oper. For more details, see our Co-Op Options and Tuition page. Provide the classroom snack on a rotating schedule. Make playdough for the classroom once a year. Follow teacher guidelines for tasks to be completed in the classroom. Be attentive to the children’s safety at all times. Promote positive interactions between children and adults. Support the BNS approach to fostering children’s independence. Have fun and learn with the children. In addition to classroom participation, all BNS parents are responsible for: Serving on either a School Committee or the School Board. Participating in Unpacking Day, Packing Day, two Saturday morning work parties and our fall and spring Rummage Sales. Attending up to four parent meetings throughout the school year, which are usually held in the evenings. Additional Responsibilities In order for my child to attend school, I must have the following information on file with the office: Any required health and emergency notification forms. A child cannot begin school until these forms are received. A notarized Release of Information form which authorizes the Office of Child Care (OCC) to have access to any files or records of child and adult abuse or neglect. (Must be submitted by the first day of school). FAILURE TO ABIDE BY THE CONDITIONS OF THIS AGREEMENT MAY RESULT IN TERMINATION OF MY ENROLLMENT CONTRACT WITH BANNOCKBURN NURSERY SCHOOL. I have read and agree to all conditions and responsibilities associated with my child’s application to, and enrollment in Bannockburn Nursery School. Parent/Guardian signature * Date: * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20192020202120222023 Application Fee and Deposit In addtion to the $60 application fee would you like to make your $500 deposit now? * Yes, I'll make my $500 deposit now No, please invoice me, I'd like to make my $500 deposit at a later date Amount due now - $00.(Total cost includes a 3% credit card service fee) Credit Card Information Issuer - None -VisaMasterCardAmerican ExpressJCBDiscoverDiners Club Credit card number Secure code Expiry date Month 010203040506070809101112 Year 202120222023202420252026202720282029 Submit