Tauxemont Cooperative Preschool, Inc.
Application Form 2014-2015
STUDENT INFORMATION
Child’s name
______
(First, Middle and Last)
What name do you and your child want us to call him/her?
Date of birth:
Gender:
Male
Female
Street address:
____________
City/State/zip code:
____________
Please list your child’s previous group and caregiver experiences (e.g., preschool, nanny, au pair, day
care, etc.) If your child has attended a day care center or preschool please list program name(s),
address(es) and dates attended: __________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
To provide the best preschool experience for your child we need to create classes that can support
different abilities. Some children need more support than others. Our classes need to have a
child/teacher ratio that will support all children.
Does your child have any special needs (e.g., motor, language/speech, psychological, emotional, social)?
____________________________________________________________________________________
____________________________________________________________________________________
Does your child have any known allergies (if so, please specify)? ______________________________
____________________________________________________________________________________
Does your child have any ongoing medical issues that may require support while in a preschool setting?
____________________________________________________________________________________
____________________________________________________________________________________
OTHER INFORMATION
Please check all boxes that apply to your family:
Current TCP member
TCP alumni (year_____)
Tauxemont community member
Previous applicant
New applicant
How did you hear of Tauxemont Preschool?
Word of mouth
Internet search
Advertisement
Other (please specify)
PARENT/GUARDIAN INFORMATION
Name of parent/guardian:
Address (if different from above):
__________________
______
________________________
Email:
____________
Cell phone:
____________
Home phone:
____________
Work phone:
____________
Name of parent/guardian:
Address (if different from above):
__________________
______
________________________
Email:
____________
Cell phone:
____________
Home phone:
____________
Work phone:
____________
Tauxemont Cooperative Preschool, Inc. admits students of any race, color, national and ethnic origin to all
rights, privileges, programs and activities generally accorded to or made available to students at the school. We
do not discriminate on the basis of race, color, national or ethnic origin in administration of our educational
policies, hiring of employees, admissions policies, or scholarships. Our program is non-sectarian, nondiscriminatory and offers no religious instruction.
FEES AND TUITION
1. Application Fee: A non-refundable fee of $50.00 per student is required with this application.
2. Annual Membership Fee: Upon acceptance, there is a non-refundable fee of $100.00 per family per
year.
3. Tuition/Tuition Deposit: Annual tuition is paid in nine equal installments. The first payment is a
nonrefundable deposit to guarantee placement in the school. The eight other installments are collected
during the school year, September through April. Tuition installments for the eight months of September
through April may be paid in full. Tuition amounts are subject to change yearly.
4. Membership Fee and Tuition Deposit are due as stated in your
acceptance letter.
DIRECTIONS
Application packet should be mailed to:
Tauxemont Cooperative Preschool Inc.
Attention: Membership
7719 Fort Hunt Road
Alexandria, Virginia 22308
Application packet should include:
1. Completed application
2. $50 application fee (Check made out to Tauxemont Cooperative Preschool)
3. After carefully reading the Family/School Agreement and Class Placement Policy, sign below
confirming that you have read and will comply with them and include this signature page with
your application
______________________________________________________________________________
I understand that Tauxemont Cooperative Preschool is a cooperative preschool, and that parent support
and participation are vital to the school’s success.
I have read the attached Class Placement Policy and the Family/School Agreement and agree to comply
with the terms as stated.
Parent/guardian’s signature:
Date:
______
Parent/guardian’s signature:
Date:
______
Please initial and date the policy and agreement and keep for your records
Tauxemont Cooperative Preschool, Inc.
Family-School Agreement
1. Parent Participation: Tauxemont is a cooperative preschool; parents are expected and encouraged to
participate in all aspects of the school to the mutual benefit of all members. Certain minimum
participation is required, as described below.
A. Parent Helping: You will be scheduled to parent help in your child’s classroom on a rotating
basis.
B. Parent Education: Our license requires that adults parent-helping in the classroom must have
four (4) hours of Early Childhood Education each year, per family. These credits can be earned
in a variety of ways including attending school meetings, attending authorized workshops, etc.
C. School Jobs: Each family is assigned a school job. These may vary with the talents, interests,
and time that individual parents have to contribute. School jobs are such that some can be done at
home, during one season, or in the evenings.
D. Meetings: As stated in our Bylaws, attendance is required by at least one parent or guardian
at Orientation. Attendance is expected by at least one family member at each All-School
Meeting. Each family represents one vote at these meetings.
D. Saturday Maintenance Sessions: Each family must participate in two scheduled Saturday
Maintenance Sessions each school year.
E. Fund Raising: Fundraising is essential to the operation of the school. Families are expected
to participate in all fundraising activities. Support of the Silent Auction is required. Support of
Fundraising activities is in addition to your family’s School Job.
2. “Buy Outs”: Tauxemont understands that full participation may not be an option for all families. We
do offer options to “buy out” of certain obligations. These options are listed below. Buy out payments
for Saturday Maintenance session, All-School Clean-up session, and school jobs are due at the time of
enrollment.
 Parent Helping: The cost of buying out of this obligation is $50.00 for each assigned day. A
family may buy out of up to one-half of their required parent helping responsibilities, they may
also have a non parent or guardian caregiver fulfill up to half of their parent-helping obligation.
For more information, contact the First Vice President for the buy out information packet
 Saturday Maintenance Sessions: The cost of buying out of this obligation is $150.00 per
session.
 Fund Raising: The cost of buying out of your Silent Auction obligation is $250.00.
 School Jobs: The cost of buying out of this obligation is $1000.00.
3. Health and Background Check Regulations: Each enrolled child and adult who participates in the
classroom must fulfill obligations, as stated in the Bylaws and required by State and County regulations.
For each child, a completed form documenting a general physical examination and proof of inoculation
must be signed by a licensed physician and submitted prior to the start of school. No child will be
admitted to school without this form on file. Also, prior to working in the classroom, each adult must
submit a completed form certifying a negative test for tuberculosis as well as have had a background
check completed by the school.
4. Provide Proof of Identity and Age: The state of Virginia requires Tauxemont Preschool to verify
within seven business day of initial attendance the identity and age of your child. Proof of the child’s
identity may include a certified copy of the birth certificate, birth registration card, passport, copy of the
placement agreement or other proof of the child’s identity from a child placing agency. If proof of
identity and age is not provided within seven business days of the child’s initial attendance, Tauxemont
preschool must immediately notify the local law enforcement agency of the situation.
5. School History: The state of Virginia requires the person enrolling a child to identify all of the
child’s day care programs and schools that the child attended and their locations (city and state).
6. Parent Participation Fines: If a family does not fulfill their parent participation obligations, the
Executive Board can levy a fine appropriate to the obligation unfulfilled and/or request the withdrawal
of your child from school. In no case shall the sum total of fines for any one family exceed $1500.00 for
the school year.
7. Suspension/Termination of Membership: Membership may be suspended or terminated by the
Tauxemont Board of Directors under the following conditions:
A. the child’s tuition is not paid; or
B. The child’s family is not fulfilling significant cooperative responsibilities; or
C. Continued membership is not in the best interest of the child; or
D. Continued membership is not in the best interest of other children; or
E. Continued membership presents a risk to the health or safety of the Preschool students,
families, or staff.
Membership may be terminated by the parents with 30 days written notice. Parents pay their
monthly tuition installment and fulfill their participation schedule for that 30 day period. The
school reserves the right to terminate Membership for any cause deemed just by the Executive
Board.
Please sign the attached application stating you have read and agree to the conditions of the
Family-School Agreement. Keep this Family-School Agreement for your reference.
Initials______
Date_________
Tauxemont Class Placement Policy
Children are placed in classes by the Membership Committee (the Directors, the President, and the
Membership Chair). Children who are currently enrolled, who will not exceed our upper age limit
(eligible for 1st grade), and whose paperwork is completed on time are guaranteed placement. The
Membership Committee places children in classes primarily by chronological age. Children may be
placed in a class outside their age range in order to best provide for their development. These
confidential and documented developmental placements are determined by the professional staff with a
child’s parents, and passed along to the Membership Committee.
There are a total of five classes held at Tauxemont Cooperative Preschool. Two morning “Threes
Classes”, two afternoon “Fours Classes”, and one morning “Fives Class” (PreK/K). The schedule,
capacity, and general age ranges for these classes are as follows:
Morning Threes Classes
2 Day 3’s: Tues. & Thurs. (9:00am – 11:45am) Downstairs Class: 12 Children; 2½’s and young 3’s
Tuition: $200/month
3 Day 3’s: Mon., Wed., & Fri. (9:00am – 11:45am) Downstairs Class: 12 Children; 3 year olds
Tuition: $250/month
Afternoon Fours Classes
4 Day 3/4’s: Mon., Tues., Wed., & Thurs. (1:00pm – 4:00pm) Downstairs Class: 12 Children; 3’s
and young 4’s
Tuition: $310/month
4 Day 4’s: Mon., Tues., Wed., & Thurs. (1:00pm – 4:00pm) Upstairs Class: 14 Children; 4 year olds
Tuition: $310/month
Morning Fives Class
Five Day 5’s: Mon. - Fri. (8:30am – 12:00pm) Upstairs Class: 16 Children; older 4’s and 5’s
Tuition: $370/month
* The above tuition fees are for the 2014-2015 school year and are subject to change.
The classes are specifically arranged by half years. Class groups are structured so that children will have
the opportunity to be familiar with new children each year. Groupings are also designed so each child is
given the chance to be in an afternoon class at some point during their career at Tauxemont.
Please sign the attached application stating you have read and agree to the conditions of the Class
Placement Policy. Keep this Class Placement Policy for your reference.
Initials__________
Date_____________