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Student Last Name First Name Middle Name Date of Birth Gender M F Nickname Name & address of previous school Dates attended Grade or Program Completed Does the student live full time with both parents? Y N If not, please describe custody arrangement & provide documentation. Parent/Guardian Name Nickname Relationship to student Home address Mobile phone Work phone Home phone Email Employer name & address Other Parent/Guardian Name Nickname Relationship to student Home address Mobile phone Work phone Home phone Email Employer name & address Ofce Use Only School Name School # Tour Date Start Date Program / Grade School Year ©2019 Spring Education Group, Inc. Applicant Information Page 1 of 2 Applicant Information

New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

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Page 1: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

Student

Last Name First Name Middle Name

Date of Birth Gender� M � F

Nickname

Name & address of previous school

Dates attended Grade or Program Completed

Does the student live full time with both parents? � Y � N

If not, please describe custody arrangement & provide documentation.

Parent/GuardianName Nickname Relationship to student

Home address

Mobile phone Work phone Home phone

Email

Employer name & address

Other Parent/Guardian

Name Nickname Relationship to student

Home address

Mobile phone Work phone Home phone

Email

Employer name & address

Of!ce Use OnlySchool Name School # Tour Date Start Date Program / Grade School Year

©2019 Spring Education Group, Inc. Applicant Information Page 1 of 2

Applicant Information

Page 2: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

Applicant Information (continued)

©2019 Spring Education Group, Inc. Applicant Information Page 1 of 2

Other Individuals Authorized to Pick-Up This Child

Contact 1 Contact 2 Contact 3

Name

Relationship

Home Address

Cell phone

Email

Work Phone

Home Phone

Receive daily photos? (y/n)

Medical

Name of Child’s Physician Physician’s Phone

Food allergies: � Y � N If yes: � Milk � Eggs � Fish � Shell!sh � Tree Nuts � Peanuts � Wheat � Soybeans � Other, Specify ____________________________________________________________

Additional NotesPlease use this space for any additional information you wish to share.

Parent/Guardian Signature

Parent/Guardian Signature Date Parent/Guardian Signature Date

Page 3: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

Brighton School ◦ 21705 58th Ave. W. ◦ Mountlake Terrace, WA ◦ 98043 ◦ 425-640-7067

Brighton School

2020-2021 Tuition and Fee Schedule

Application Fee: $125

Non-refundable fee due with application

Please circle appropriate tuition payment.

Registration Annual Semi-Annual Monthly

(5% discount) (2.5% discount) ACH Sept-June

March 31, 2020 March & January ACH – 10 Monthly

Payments

Preschool 3 Day AM Preschool $285.00 $5,377.00 $2,759.25 $566.00

3 Day Full Day Preschool $285.00 $7,913.50 $4,060.88 $833.00

5 Day AM Preschool $550.00 $8,027.50 $4,119.38 $845.00

5 Day Full Day Preschool $550.00 $13,214.50 $6,781.13 $1,391.00

PreKindergarten 5 Day AM PreKindergarten $550.00 $8,027.50 $4,119.38 $845.00

5 Day Full Day

PreKindergarten $550.00 $12,720.75 $6,527.63 $1,339.00

Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00

Middle School 6th - 8th Grade $850.00 $16,454.00 $8,443.50 $1,732.00

Extended Care Before Care

After Care

$214.00

$308.00 Before and After Care $428.00

Student Information Parent / Guardian Name Signature Referred By Street Address City, State, Zip Code Phone Number Email Address Student Name Student Date of Birth Gender Grade Level 2020/21

Page 4: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

ADMISSIONS PROCEDURES - Both you and your child (named below) (“your child”) must comply with all School admissions policies and procedures. Effectiveness of this Tuition Agreement is subject to final approval of your child’s admission in accordance with such policies and procedures, notwithstanding the “acceptance” of this Tuition Agreement reflected by the Principal’s signature below.

TUITION - The School Year is from the First Day of School to the Last Day of School, as reflected on the School Calendar (each attached hereto and made a part hereof ). You agree to pay tuition and fees for your child for the entire School Year (or, if your child is starting after the First Day of School, from the starting date (as agreed in writing with us)) through the Last Day of School, subject to the Early Withdrawal policy set forth below. You may pay tuition in any installment plan reflected as an option on the Fee Schedule. In addition to the tuition and fees set forth in the Fee Schedule, you will pay for any extra charges incurred by your child for care or activities which are applicable.

TUITION DUE / LATE CHARGES - Tuition and fee payments are due and payable at the times stated on the Fee Schedule. Tuition and fees are considered delinquent at 12:00 noon on the day following the due date. Late charges will be assessed in amounts as reflected on the Fee Schedule commencing at that time. If tuition and any other outstanding charges are not paid within seven days of the date due (or within five banking days of notification to you, in the case of a returned check), attendance at the School will no longer be permitted until tuition is paid in full for the past due amount and for the current period.

RETURNED CHECKS - A service charge will be assessed in amounts as reflected on the Fee Schedule for a check returned for any reason. In addition, a late charge will be assessed as reflected on the Fee Schedule, unless payment is received to cover the funds within three banking days of notification. If your check is returned three times within a three month period, then for a period of one year, you must make all payments by money order or certified check, or by cash (subject to the policy on “Cash Payments”).

CASH PAYMENTS - For your protection, cash payments may be made only to the Principal or Assistant Principal of the School or the administrative employee designated on the School’s bulletin board as being so authorized. If the payment is for an amount of more than $5.00, it will be invalid unless you obtain a computer generated cash receipt from the school’s financial operating system.

EARLY WITHDRAWAL - Withdrawal from the School during the School Year requires at least one month’s advance notice. You must continue tuition payments for attendance through the date which is one month after our receipt of your withdrawal notice.

HOLIDAYS / IN-SERVICE DAYS - Tuition and fees are calculated on an annual basis, without reduction for holidays, vacations, professional in-service days for our teachers or student absences or illness. Holidays and professional in-service days for the School Year are shown on the School Calendar. No credit/refund will be owed if the School must close because of emergency or inclement weather.

HOURS / EXTENDED CARE / LATE PICK-UP CHARGE - The hours of the School are shown on the Fee Schedule and/or School Calendar, including: the time our extended care program starts in the morning, the time you may first drop off your child if he or she is not registered for extended care, the start of classes, the end of classes, the time by which you must pick up your child if he or she is not registered for “extended care”, and the time our extended care program ends (and the School building closes). Extended care requires registration and charges as reflected on the Fee Schedule. Fees for early drop off and for late pick up are set forth on the Fee Schedule. If your child is picked up several times after the School building’s scheduled closing time, we may increase the applicable fee.

FAMILY DISCOUNTS - Families with more than one child enrolled full-time at Spring Education schools may receive a discount for each additional child after tuition has been paid at the regular full-time rate for the child with the highest regular tuition rate (i.e., the discount will be a percentage of the lower tuition amount). See the Fee Schedule for details.

DRESS CODE - Students are required to comply daily with the School’s dress code.

SUSPENSION / DISMISSAL - We reserve the right to suspend or dismiss a child in our sole discretion for unsatisfactory or inappropriate behavior, if we do not have adequate expertise or resources for the child’s educational, medical or other needs (subject to any applicable regulatory requirements), for violations of our policies, or if for any reason we determine it to be in the best interests of the School. In our sole discretion, suspension or dismissal may be with or without notice.

Northwest Elementary School Page 1 of 2©2019 Spring Education Group, Inc.

School Name: __________________________ School # __________ School Address: ________________________________________________

Elementary School Tuition Agreement (NW)

Page 5: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

STUDENT ILLNESS / EMERGENCY - We strive to maintain a healthy, safe environment for our children. In that light, you may not bring to the School a child who is ill (determined in our discretion). We will notify you if your child becomes ill, and you must then pick him/her up as soon as possible. You authorize us to obtain immediate medical care if a medical emergency occurs when you cannot be located immediately. Such care may be from a physician or hospital other than your child’s physician, if, in our judgment, there is insufficient time first to contact your child’s physician. You authorize us to make the decision of when an emergency exists.

USE OF PHOTOGRAPH, ETC. - You authorize us to use your child’s photograph or appearance in any advertising or other media.

INTERNET USE - You recognize that, while the Internet has the potential to provide vast resources and tremendous learning opportunities for our students, searching the Internet can expose your child to dangerous or inappropriate material. You agree to release the School and its employees from all claims, charges and damages of any nature arising from use or misuse of the Internet. You further agree that the School may condition your child’s use of the Internet upon execution by you and your child of further documentation as may be required by the School.

RENEWAL - Registration at the School is on a School Year basis. Your child will not be guaranteed a reservation for the following school year, unless you enter into a new tuition agreement with the School for that school year and pay all applicable fees.

RESPONSIBILITY - You agree that you will be responsible for any loss, damage or destruction by your child of any property of the School and for any dam-ages for which the School becomes liable or chargeable because of your child’s actions.

STUDENT RECORDS - All student records remain the property of the School, except as may otherwise be provided by law. You authorize us to send academic records and confidential recommendations to schools your child attends after our School upon the request of such schools, and you will not seek access to confidential recommendations and evaluation materials. Further, you release our School and our staff from any and all liability resulting from or pertaining to the furnishing of recommendations and records.

COSTS OF COLLECTION - If we refer your account for collection, you will pay all our costs of collection, including (but not limited to) attorneys’ fees.

Northwest Elementary School Page 2 of 2©2019 Spring Education Group, Inc.

Name of Student _____________________________________________ Date ______________________________________________

Sponsor Signature ____________________________________________ Print Name ________________________________________

Sponsor Signature ____________________________________________ Print Name ________________________________________

ACCEPTED

Principal Signature Print Name

I agree to the above terms and conditions, including the obligation to pay to the School all charges for tuition and fees, and in all events to be responsible for the financial obligations of my child.

Elementary School Tuition Agreement (NW) (continued)

School Name: __________________________ School # __________ School Address: ________________________________________________

Page 6: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

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Page 7: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

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Page 8: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

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Page 9: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

Childhood Health History 9/2007tro

Childhood Health History

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Page 10: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

Childhood Health History 9/2007tro

Nutrition History ,V�WKHUH�DQ\�IRRG�RU�GULQN�WKDW�\RXU�FKLOG�VKRXOG�QRW�HDW�IRU�FXOWXUDO��UHOLJLRXV��SHUVRQDO�UHDVRQV�RU�PHGLFDO�UHDVRQV�other than allergies"��1RWH��XVH�WKH�DOOHUJ\�FKDUW�RQ�WKH�QH[W�SDJH�WR�OLVW�DQ\�DOOHUJLHV�WR�IRRG�RU�GULQN��

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�No – Skip to Dental History�

Allergy Chart Note: If your child has a food or milk allergy, we must have written documentation of the allergy from the doctor. For milk allergies, the doctor must also name a substitute for the milk. 'R�\RX�NHHS�HSLQHSKULQH��HSL�SHQ��DYDLODEOH�DW�KRPH�IRU�\RXU�FKLOG¶V�DOOHUJ\"� <HV� 1R List each allergy or food separately

Briefly describe child’s reaction and/or check symptoms

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Page 11: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

Childhood Health History 9/2007tro

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Page 12: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

Parent Input To be completed by parent or guardian

Student Name: Date of birth:

School or program student is currently attending: (if applicable)

What are the first three words that come to mind when describing your child?

What do you see as your child’s strengths?

What are your child’s favorite subjects in school?

What do you see as your child’s social and academic challenges if there are any?

What educational and social goals do you have for your child?

Please list outside hobbies, sports, and other interests your child is presently or has formerly participated or been interested in:

Check the words that best describe your child

Ƒ�Curious Ƒ�Creative Ƒ�Irritable Ƒ�Organized Ƒ�Enthusiastic Ƒ�Anxious Ƒ�Easily discouraged Ƒ�Manipulative Ƒ�Over-protected Ƒ�Self-disciplined Ƒ�Articulate Ƒ�Follower Ƒ�Motivated Ƒ�Perfectionist Ƒ�Shy Ƒ�Cheerful Ƒ�Helpful Ƒ�Mature Ƒ�Positive Leader Ƒ�Social Ƒ�Confident Ƒ�Honest Ƒ�Negative leader Ƒ�Responsible Ƒ�Vivacious Ƒ�Conscientious Ƒ�Immature Ƒ�Oppositional Ƒ�Attentive Ƒ�Aggressive

Signature of Parent or Guardian Date

Page 13: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

Student Input�7R�EH�FRPSOHWHG�E\�VWXGHQW�LQ�KDQGZULWLQJ�

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A. School Activities �����

B. Other Activities ������

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Page 14: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

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Page 15: New Elementary (1-8) Enrollment Applicant Packet 2020 · Elementary Kindergarten - 5th Grade $650.00 $15,646.50 $8,029.13 $1,647.00 Middle School ... from the school’s financial

Would your child need assistance and/or modifications in order to fully participate in this school’s programs and services?

Check one: � Yes � No

Requests for assistance and/or modifications must be made to this school’s Head of School/Principal, Assistant Head of School/Assistant Principal and/or Spring Education’s ADA Compliance Officer. An enrollment decision will not be made until the request has been decided upon by the ADA Compliance Officer.

Pre-Enrollment Modification Inquiry Form

This school does not discriminate based on disability in its provision of educational programs and services.

©2019 Spring Education Group, Inc.

Student Info

Student Name Program/Grade

Sponsor Signature Print Name

Sponsor Signature Print Name

School InfoSchool Name School #

Principal Signature Date

Print Name

Pre-Enrollment Modification Inquiry Form