Tvms Admission Information

136 Northridge Road Marble Falls, TX. 78654 830.693.7007 www.tierravista.org

ADMISSION INFORMATION Date: ____________________________________________ Date of Birth: _____________________________________ Child’s Name: ________________________________________ _____ Phone #: ____________________ Home Address: ________________________________________City: __________________Zip: ________ E-Mail Address: __________________________________________________________________________ Father’s Name: _____________________________________________ Phone #: _____________________ Address: ______________________________________________City: ___________________Zip: _______ Business Address: ___________________________________________ Phone #: _____________________ Address: ______________________________________________City: ___________________Zip: _______ Mother’s Name: _____________________________________________ Phone _______________________ Address: ______________________________________________City: ___________________Zip: _______ Business Address: ___________________________________________ Phone #: _____________________ Address: ______________________________________________City: ___________________Zip: _______ Person(s) to contact in case of emergency: Name: __________________________________________________

Phone #: _____________________

Name: __________________________________________________

Phone #: _____________________

Physician’s Name: _________________________________________

Phone #: _____________________

Address: ______________________________________________City: ___________________Zip: _______

136 Northridge Road Marble Falls, TX. 78654 830.693.7007 www.tierravista.org ENROLLMENT AGREEMENT 1. In consideration of TIERRA VISTA MONTESSORI, INC., hereafter called Tierra Vista, furnishing our child, _____________________________________, with care, guidance and supervision according to the Montessori pedagogical standards of the Association Montessori Internationale and the American Montessori Society, we agree to pay Tierra Vista Montessori School at 136 Northridge Road, Marble Falls, Texas 78654, according to the terms of the Tuition Schedule listed below. Because Tierra Vista Montessori School is a year-round school, the tuition is due monthly until your child graduates from the program or is withdrawn from the school with a 30-day notice. 2. All tuition payments will be made on or before the dates as specified on page 5 of this document under the heading “Late Pick-Up/Payment Penalty”. Payments become delinquent 5 days after the due date; late fees as specified in the penalties statement then become applicable. In the event any one payment remains delinquent for 30 days after the due date, the child will be withdrawn from Tierra Vista and the unpaid balance plus late fees will become immediately due and payable. 3. We understand that Tierra Vista depends substantially on tuition payments and fees from full enrollment to meet its financial obligations and to satisfy its educational commitment to its students. Accordingly, there will be no reduction or refund of tuition or fees for the withdrawal or absence of our child for any reason other than those expressly stated in paragraph 4 and/or paragraph 5. We acknowledge that we are responsible for the applicable full year’s tuition and fees for our child. 4. The foregoing notwithstanding, if we withdraw our child from Tierra Vista because of our being transferred out of the Marble Falls area or because of our child’s serious illness that prevents him/her from participating further in the Tierra Vista program, we understand that we are required to give at least 30 days prior written notice of such withdrawal.

Enrollment Agreement

Page 1 of 4

ENROLLMENT AGREEMENT (continued)

5. We understand that all students are expected to abide by the regulations and behavioral standards of Tierra Vista. Tierra Vista will make every reasonable effort to work with the students and parents to arrive at appropriate solutions to any problems, which may arise. Tierra Vista reserves the rights to require immediate withdrawal of such students when agreement cannot be reached between the parties, or the problems are not satisfactorily resolved. If Tierra Vista requires withdrawal of our child for such reasons, all-remaining tuition and fees for our child for the balance of the year will be waived, provided payments are current as of the date of withdrawal. 6. This enrollment is not subject to revocation. Tierra Vista, except herein expressed in writing, will recognize no verbal modification or representations. This enrollment shall be effective only upon acceptance by Tierra Vista of this signed agreement and our payment of the applicable registration fee.

Parent: ___________________________________________________________

Date: ___________

Parent: ___________________________________________________________

Date:___________

Tierra Vista Montessori, Inc. agrees to: •

Release your child only to you or to the persons designated by you below on this enrollment agreement;

•

Keep you informed of special problems and/or occurrences which may affect your child, including incidences of

communicable diseases, accidents; •

To hold parent-teacher conferences twice a year. We also agree to make time by appointment at your request to

discuss special problems or occurrences affecting your child or to answer any questions you may have. •

To not discriminate against applicants and students on the basis of race, color or national or ethnic origin.

Enrollment Agreement

Page 2 of 4

ENROLLMENT AGREEMENT (continued)

LATE PAYMENT PENALTY Tuition payments are due on the 20th of the month. Payments received after the 25th of the month will incur a $20.00 late penalty fee. In the event any one payment remains delinquent for 30 days after the due date, the child will be withdrawn from Tierra Vista and the unpaid balance plus late fees will become immediately due and payable. For the child’s sake, every attempt will be made to work with parents under special circumstances.

TUITION AGREEMENT Tuition for your child is $_________monthly (including snack and lunch) plus additional $_______after-school fee (if applicable). In addition, upon registration, you will owe a registration fee of $200 and a tuition down-payment equal to one month’s tuition. There are no discounts during periods of school breaks, such as winter break, spring break, summer break, and/or holidays. Please refer to fee schedule for program specific fee information.

PERMISSION TO RELEASE INFORMATION PLEASE RELEASE OUR CHILD: ___________________________________________________________ TO THE PERSON(S) WE HAVE NAMED BELOW: Name: ______________________________________________ Phone#: ________________________ Address: _____________________________________________ DL#: __________________________ Name: ______________________________________________ Phone#: ________________________ Address: _____________________________________________ DL#: ___________________________ Name: ______________________________________________ Phone#: ________________________ Address: _____________________________________________ DL#: __________________________ Name: ______________________________________________ Phone#: ________________________ Address: _____________________________________________ DL#: __________________________

Enrollment Agreement





Page 3 of 4

ENROLLMENT AGREEMENT (continued)

ADDITIONAL REQUIREMENTS FOR ADMISSION: _______(initials) I have received the Parent Handbook updated January 2006. I know that it is my responsibility to read and adhere to the guidelines in that handbook.

_______(initials) I understand that I am responsible for keeping immunizations current according to the attached immunization list. I know that I have 30 days from the first day of school to report current and complete records to the school office.

_______(initials) I have received the Health Information Form and the Authorization for Emergency Medical Attention Form. I understand that these forms are due by the start of the school year.

_______(initials) I agree that my child may participate in any school-sponsored field trip unless the school receives written notice to the contrary. I will be notified of field trips prior to the event.

PARENT: _______________________________________________________ DATE: _______________

PARENT: _______________________________________________________ DATE: _______________

Enrollment Agreement





Page 4 of 4

136 Northridge Road Marble Falls, TX. 78654 830.693.7007 www.tierravista.org Tuition and Fee Schedule for 2009-2010

I would like to enroll my child, _________________________________ in the program selected below. child’s name

If there are no openings available, my child’s name will be placed on the waiting list. Please contact me, ______________________________ at __________________________________________ when an parent’s name

pnone #(s)

opening becomes available.

a

Program

Hours

Monthly Tuition Payment

Toddler 3 Day Toddler 5 Day Primary 4 Day Primary 5 Day

8:30 - 2:30 8:30 - 2:30 8:15-2:45 8:15-2:45

$430 $540 $465 $525

(includes $30 snack & lunch fee) (includes $40 snack & lunch fee) (includes $40 snack & lunch fee) (includes $50 snack and lunch fee)

Payment Plan Options: Annual, Semi-Annual, Monthly Registration Fee: A registration fee of $200 per family and a tuition down payment equal to one month of tuition are due before admission to the school. Monthly Payment Plan: Tuition down payment of 1 month due by June 1st and remaining payments are due on the 20th of each month for the following month. Tierra Vista does not discriminate against applicants and students on the basis of race, color, or national or ethnic origin.

________________________________________________ Parent Signature Tuition and Fee Schedule

______________________ Date