Child’s Name: ___________________________________ Birthdate: ______________________________ Parent Name: ___________________________________ Home School: ___________________________ Address: _________________________________ School Choice: __________________________ City: ______________ Zip Code: ____________ Alternate Choice:________________________

Program Options:

Pre-K

□ AM ($350 per month)

□ PM ($350 per month) Options: Hermosa Vista Franklin at Brimhall RMRE Zaharis

Pre-K & Child Care

□ Part time AM ($450 per month)

□ Full time ($650 per month) Options: Franklin at Brimhall RMRE Zaharis Dobson High Mesa High Red Mountain High Skyline

Montessori Philosophy is characterized by an emphasis on independence, freedom within limits, and respect for a child's natural psychological, physical, and social development □ Full Time ($500 per month)

□ Montessori AM ($400 per month) Option: Pomeroy

Payment Contact (name): Preferred Phone:

Preferred Email:

Does your child have any special needs: □Yes □No IEP in Place: □Yes □ No *IEP’s require approval by director*

Is either parent an employee of Mesa Public Schools? □Yes □No If Yes, Employee Name:_______________________

MPS EIN:_______________ Position:_______________________ School/Department:______________________

Requirements

1. Complete KinderU tuition forms. 2. Child must be reliably potty trained. 3. Age appropriate for program choice. Tuition Age: Birthdate before 8/1/2017. 4. First month’s tuition for all tuition-based programs payable by July 31st,2020. 5. Submit forms via email to early_learning@mpsaz.org

Community Education – KinderU 855 West 8th Avenue, Mesa, AZ 85210

Information: www.mpsaz.org/kinderu

Phone: (480) 472-7250 Hours of Operation 8:00am – 4:30 pm (Monday – Thursday) Close 4:15 Friday

2020-2021

5/4/20

Our promise is Our Mission Every Mesa Public School Student is known by name, served by strength and need, and graduates ready for college,

career and community.

Rev: 5/20/20

➢ I will provide daily transportation for my child.

➢ I will bring my child and pick him/her up on time each day. I understand that continual tardiness may result in

removal from the program.

➢ I understand my child will need to be signed in and out each day by me or by another adult (18 years or older)

who has written permission on file at the school. I will call the school if my child will be absent due to illness,

etc. I also understand that unreported continual absences will result in my child’s removal from the program

➢ I understand my child will receive vision, hearing, and dental screening while enrolled in the program.

➢ I understand the state of Arizona requires continuous ongoing assessment of each enrolled student.

➢ I understand that biting, kicking, and grabbing toys away from others are common behaviors when young

children are in large group settings for the first time. I agree to work with school staff to support each child and

family as children move through this period and learn to interact with others.

➢ I understand school staff must be able to contact me during the school day in case of an emergency. I agree to

keep the teacher and school staff notified of any changes to my personal phone numbers, or the numbers of

those individuals with written permission to sign my child out of the classroom.

➢ I agree to update my child’s immunizations and provide the school office with a copy of the updates as

required.

➢ I understand a late pick up fee of $25.00 will be assessed for picking up my child 1 to 15 minutes late and an

additional charge of $25.00 for each additional 1 to 15 minutes.

➢ I understand there are no refunds or credits for unused days.

➢ I understand that if at any time my account is delinquent, my child will be dismissed from the program.

➢ I agree to the terms and conditions of the KinderU program as outlined in the parent handbook and payment

policy.

➢ I understand that if I have automatic payments, if the card on file declines two times in a school year, the

account will become ineligible for automatic payments.

➢ I authorize the use of the following email address for registration, tuition and other accounting

communication.

Parent/guardian name (Printed): ________________________________________________________________________

Parent /guardian signature: ____________________________________________________ Date: __________________

Email: _______________________________________________________________________________________________

Parent Agreement

Our Promise is Our Mission Every student in Mesa Public Schools is known by name, served by strength and need, and graduates

ready for college, career and community.

Revised 5/4/20

Preschool only - 4 days/3 hours per day (No class Wed.) $350.00

Preschool with wrap around childcare – full day of learning and care 7 – 5:30 (5 days) $650.00 Preschool with wrap around childcare – half day of learning and care 7 – 12 (5 days) $450.00

Montessori – full day $500.00 Montessori – half day $400.00

PAYMENT POLICY Payment Policy: KinderU program fees are charged monthly and are due on or before the first business day of the month by the close of business. You will not receive an invoice. Late Payment Fee: If your account is delinquent, a late payment fee of $25.00 will be assessed on the second business day of the month. Payments: Payments are not accepted at individual school sites. Payments may be mailed or delivered in person: Mesa Education Center- KinderU

855 West 8th Avenue, Mesa, AZ 85210 Or 24 hour drop box is located on the west side of the office. No cash or credit card information in drop box. Acceptable forms of payment:

Checks made payable to MPS- KinderU Cash Money order Online payments via MyProcare.com (Visa, MasterCard, Discover and American Express) Automatic payments via Tuition Express (form required)

NSF or returned checks will be charged a $25.00 fee per check. You may be required to provide a cashier’s check or money order for future transactions in Community Education. Two declined credit card notices the account will become ineligible for automatic payments for the rest of the school year. Additional Fees Late Pick Up fees – per child:

1 – 15 minutes late = $25.00 Each additional 1 to 15 minutes = $25.00

Please make arrangements for an alternate person listed on the emergency card to pick up your child if you are going to be late. Withdrawal Policy: Students will be dropped from a tuition or scholarship program if at any time the account is delinquent on tuition payments and/or imposed fines. Services will not be available until the account is current without regard to multiple financially responsible parties. Refunds: There are no refunds or credits for unused days.

2020 - 2021 Monthly Program Fees