THE FOREST HILLS JEWISH CENTER NURSERY SCHOOL & KINDERGARTEN
106-06 Queens Blvd., Forest Hills, NY 11375 Susan Rosenbaum
(718) 263-7000 Ext. 220 Director of Early Childhood Education
2016-2017 REGISTRATION AND TUITION CONTRACT
Please check the choice that applies to your family:
__(a) The undersigned are the parents (or guardians) of this child, who is Jewish according to Jewish law (i.e., born of a Jewish mother). Should you have any questions pertaining to the religious status of your child because of adoption or conversion, we request that you discuss them with Rabbi Skolnik, the Rabbi of this synagogue.
__(b) The undersigned are the parents (or guardians) of this child, whose father is Jewish, but whose mother is not.
Should section (b) apply to you and your child, please complete the form below, and consult further with our Nursery School Director, Susan Rosenbaum.
Child’s Name ______|______Hebrew Name______
Last First
Child’s DOB: ______¨ Three Year Old Program ¨ Four Year Old Program
Parent #1 ______|______|______|______Cell #______
Last First MI Hebrew Name
Parent #2 ______|______|______|______Cell #______
Last First MI Hebrew Name
Email Addresses ______|______
Parent #1 Parent #2
Home Address ______|____|______NY_|______|______
Number/Street Apt# City Zip Home Phone #
Parent #1 Occupation ______Company Name ______
Business Address ______|______|______|______
Number/Street City/State Zip Business Phone #
Parent #2 Occupation ______Company Name ______
Business Address ______|______|______|______
Number/Street City/State Zip Business Phone #
Program(Please Check One) / Time / Tuition / Early Morning Drop Off
(7:45 am- 9:00 am)
[ ] Half Day Program (3 year olds only) / 9am – 12pm / $8,250 / $1,900 (Or $17/Day or $64/Week)
[ ] Transition Program (3 year olds only)
[ ] Full Day Program / 9am - 12pm Sept. – Oct.
9am - 2pm Nov. - June
9am – 2pm / $10,400
$10,900 / $1,900 (Or $17/Day or $64/Week)
$1,900 (Or $17/Day or $64/Week)
[ ] Extended Day Program / 7:45am – 6pm (M – Th)
7:45am – 2pm (Fridays) / $15,100 / Included
Discounts to be subtracted –
FHJC Members – / Dues Deduction: $______/ Tuition: $ ______A credit will be applied in proportion to the
number of hours your child attends school.
Siblings – Half Day - $325.00 / $______/ Early Morning Drop Off: $______
– Full Day - $450.00 / Security Assessment $ 300.00
– Extended Day - $600.00 / Enrichment Fee $ 105.00
Sibling discount goes towards youngest sibling
Refer-a-Friend Discount - $250.00
Non-FHJC Affiliated Only. / $______/ Subtotal $______
Early Registration Discount – / $______/ Total Discount $______
· 3% Discount - Register before Fri., March 11th, 2016
/ 2% - 10 Payment Surcharge $______
TOTAL TO BE PAID:
DEPOSIT PAYABLE UPON SIGNING CONTRACT (NON-REFUNDABLE): $ 1,000.00
Additional Deposit: $______
BALANCE DUE: $______
PAYMENT OPTIONS
I/we agree to pay the aforementioned balance due in the following manner:
¨ One payment on August 15th, 2016.
¨ Two equal payments to be made on June 15, 2016 and November 15, 2016.
Two post-dated checks, OR two payments on your credit card, must be submitted with this contract
¨ Ten equal monthly payments (May 15, 2016 through February 15, 2017). 2% Surcharge will be added.
Ten post-dated checks, OR ten payments on your credit card, must be submitted with this contract
* For enrollment after May 15th, all payments scheduled prior to date of enrollment must be made at the time of enrollment.
I/We, the undersigned, hereby enroll our child in the Forest Hills Jewish Center Nursery School and Kindergarten, for the school year beginning September 2016 and ending June 2016, pursuant to the terms and conditions specified in the student handbook and the following additional terms and conditions:
1. If you withdraw from FHJC prior to July 15, 2016, all but the $1,000 non-refundable fee will be reimbursed. From July 15, 2016 – August 15, 2016, 3 months tuition including the $1000 deposit is non refundable. One month’s tuition is calculated as 1/9 of the full tuition. After August 15, 2016 no refunds will be granted and full tuition is due and payable.
2. In the event of a medical emergency, it is agreed that if the undersigned cannot be reached by telephone, permission and consent are given to the school to obtain proper emergency medical treatment for the child.
3. The Forest Hills Jewish Center Nursery School and Kindergarten reserves the right to terminate this agreement at its discretion when it deems such action to be necessary. In such an event, tuition will be refunded, on a prorated basis, minus the non-refundable registration fee.
4. Unless written notice is received with this application, you hereby authorize the Forest Hills Jewish Center Nursery School and Kindergarten to display pictures or images of your child in our school and in publicity materials.
5. Class placement is made at the discretion of the director.
6. If enrollment in any class is not sufficient to open a class, as reasonably determined by the Forest Hills Jewish Center Nursery School and Kindergarten, a full refund will be given.
One Reciprocal Friend Request ______
It is expressly understood and agreed by the parties hereto that the privilege of paying tuition installments is extended only as a convenience and does not in anyway vary the obligation of the applicant to pay the tuition in full. Each installment is automatically due on the date stated. The school hereby makes it known to the applicant that his/her child is being accepted for the entire year and that the tuition stated is payment for a place in the school and not for the period of attendance. It is also understood that this installment method payment privilege will be revoked if we fail to comply with the above terms. All balances will then become immediately due. I/we further understand that this contract covers only those items mentioned (i.e. tuition and registration fee).
______
Parent #1 Signature Parent #2 Signature Date
______
Early Childhood Director Date
*In order to properly plan our classes and hire the best possible staff, we need to have enrollment
information by June 1st, 2016.
Child’s Siblings’ Names and Ages:
Name: ______Age: ______
Name: ______Age: ______
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MasterCard [ ] Visa [ ] Discover [ ] Dated Checks [ ]
Minimum registration is required for all classes
Credit Card #: ______Sec: ______Expiration Date: ______
Payment Schedule: ______