Juniata College Early Childhood Education Center
1700 Moore St., Huntingdon, PA 16652
814-641-3401
Enrollment Form 2016-17
I/We wish to enroll in the Early Childhood Education Center at Juniata College. Child’s Nickname______Date of birth______
Parent/Guardian # 1: Name______Phone (H)______(W)______(C)______
Home address______
Parent/Guardian # 2: Name______Phone (H)______(W)______(C)______
Email (s) ______
Monthly billing statements and weekly newsletters are electronically distributed. May we use your email address(s) in a family distribution list? Yes____ No ____
Please check:Fall Semester (9/1/16-12/9/16) Spring Semester(1/16/17-5/2/17) ______
My child will attend:Please check all sessions:
Day of Week / AM 8:30 to 11:30 / PM 12 to 3 / All dayMonday
Tuesday
Wednesday
Thursday
Friday / No classes / No classes
Tuition Cost / Two days / Three days / Four days / Five days
Half day / $390/semester / $585/semester / $777/semester / $972/semester
Full day / $813/semester / $1224/semester / $1626/semester / $1821(4 ½ days)/semester
Multi-Child Discount: After the first child, each additional child from the same family will get a 25% discount off the lower applicable full tuition.We accept CCIS subsidized care.
Tuition Payment:
We agree to pay tuition in the amount of /semester, to be billed in three installments (Sep., Oct., Nov. for Fall Semester & Feb., Mar., Apr. for Spring Semester.) Information about tuition grants is available from the director.Failure to pay can result in Collection Agency/Credit Bureau reporting.Any fees associated with the collection process are the responsibility of the person signing the contract.
Directory:
We may publish a directory to distribute only to families whose children attend the center. Please check the items below to give us permission to include you and your child in the directory:
Your child’s name____, your name____, address____, phone number____, prefer not to be included ____
Center Statements:
The Early Childhood Education Center is a laboratory school serving college students as well as community families. Children are involved in a program that prepares teachers and others in related professions to work with young children. Students are videotaped at work so that they can evaluate their own performance. They also take photographs of themselves working with the children to document their work for their professional portfolios.I have read the above statement and understand that my child may be observed, photographed and participate in student initiated activities. Other activities, such as an in depth study for a case record, special tutoring, or participation in a research study, will be conducted only if I grant specific permission.
Date Parent/Guardian signature
As noted above, photographs are often taken to demonstrate the children’s and the college students’ work within the center and the community. Photographs of my child may be used for educational and promotional purposes: Yes___ No___
If my child is accepted to attend the ECEC, I understand that I will receive a written copy of complete program information.
Date______Parent/Guardian Signature______
Date______Center Director Signature______