Afternoon Program Registration 2012-2013

* Your Name

* Your Last Name

* Email

* Child's First Name

* Child's Last Name

* Class

Please select the days for which you would like to enroll.

MONDAYS -- September 10th - June 10th (27 Sessions)

Cost $756 + Materials Fee (includes snack) $60 = TOTAL $816

TUESDAYS -- September 11th - June 11th (33 sessions)

Cost $924 + Materials Fee (includes snack) $60 = TOTAL $984

WEDNESDAYS -- September 12th - June 12th (34 sessions)

Cost $952 + Materials Fee (includes snack) $60 = TOTAL $1012

THURSDAYS -- September 13th - June 6th (34 sessions)

Cost $952 + Materials Fee $60 (includes snack) = TOTAL $1012

FRIDAYS -- September 14th - June 7th (30 sessions)

Cost $840 + Materials Fee (includes snack) $60 = TOTAL $900

ALL WEEKDAYS -- Monday, September 10th - Wednesday, June 12th

Cost $4424 + Materials Fee (includes snack) $300 = TOTAL $4724

Registration Fee (required)

$41

Discounts*

30% -- for 5 Day Registrants before August 31st

**15% Discount if you register for 5 Days a week AFTER August 31st**

20% -- for 3-4 Day Registrants (before August 31st)

**10% Discount if you register for 3-4 Days a week AFTER August 31st**

10% -- for Sibling 1-2 Registrants Only (only largest discount applies)

* The business office will calculate the total amount due taking into account any applicable discounts and will
invoice you accordingly.

* Do you wish to have a payment plan?

Yes

No

Your payment plan will include a total of 2 payments. The first payment will be invoiced and due now, and the second payment will be due before January 6th, 2013.

* By checking this box, I understand and agree that I will be receiving an invoice from The Brooklyn Waldorf School at the email address I have provided in this form for the Early Childhood Afternoon Program services I have selected in this form and that I will be expected to pay this amount in full, either in one or two payments as I have also indicated in this form.

Please check here if you understand and agree with the above statement.

Thank you! You will soon receive and email invoice with payment instructions.

* Indicates Response Required