Registration Form

School Year 2016-2017

(Questions ? email them to principal @sedaliastpauls.net)

Emergency Phone #___________________________

Date of registration___________________________

1st Child: Name: ________________________________________

Age: ______Date of Birth: ____________Entering Grade: _____M/F: ______

Baptized :( Y/N) _________Allergies:________________________________

2nd Child: Name________________________________________

Age: ______Date of Birth: ____________Entering Grade: _____M/F: ________

Baptized: (Y/N)________ Allergies:________________________________

3rd Child: Name_______________________________________

Age: ______Date of Birth: ____________Entering Grade: _____M/F: ________

Baptized: (Y/N)_________ Allergies:________________________________

FAMILY INFORMATION:

Father’s name: _______________________

Dad Cell#_________________________

Mother’s name: ______________________

Mom Cell#________________________

Father's employer: ___________________________________________

Mother's employer:___________________________________________

Dad’s work/ phone: _______________

Mom’s work/phone: _____________________

Home address: _____________________________________________

Home phone: ______________Previous School: ____________________

Primary e-mail: ____________________________________________

Secondary e-mail:__________________________________________

Church affiliation: __________________________________________

Registration: (non-refundable)- Grade PK-8 ($100)__________

Tuition is paid through FACTS unless paid for the whole year.

Single Payment - 3% discount (due by the 1st day of school)

Log in at:  https://online.factsmgt.com/SignIn.aspx

Have Questions?  You may also call FACTS Corporate office toll-free at 866.441.4637


 

FEES: Must be paid by all families

*Books/Materials per child - Grade K-8 ($200) ____________________

*Technology fee per child-Grade K-8 ($50) _______________________

*Books and Technology fees may be added to FACTS payment.

Tuition Rates (established 11/12/15)

COMMUNITY AND LCMS – PK Rate - $3150 /year (all PK students)

Single Pay - 3% discount

       Community Rates K-8:_______

1st Child $ 2680/year ($268/mo)

2nd Child $ 2140/year ($214/mo)

3rd Child $ 1610/year ($161/mo)

4th Child $ 1070/year ($107/mo)

5th Child $    540/ year ($54/mo)

 

LCMS Church members rate K-8:

1st child $ 2100/year ($210/mo)

2nd child $ 1680/ year ($168/mo)

3rd child $  1260/year ($126/mo)

4th child $     850/ year ($85/mo)

5th child $     420/year ($42/ mo)

 

Needed before first day of school:

_____Immunization records

_____Birth Certificate

_____Social security number

_____Request for Records from Previous School

_____Signed receipt of Handbook


 

____Portion of divorce decree/legal document that assigns custody and any other information from legal document pertinent to guardianship and school enrollment, if applicable

 

In the event you are unable to reach me in case of an emergency or disciplinary problem, the following person(s) may assume responsibility for my child. Only those listed will be allowed to pick up your child from school.

1)__________________________ Phone # _____________

Relationship _________

 

2)_________________________ Phone # _________________

Relationship _________

 

3)_________________________ Phone # _________________

Relationship _________

 

4)_________________________ Phone # _________________

Relationship _________

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