Parish Tuition & Fees Payment Agreement 2015-2016
Father's Name:
Work or Cell:
Mother's Name:
Work or Cell:
Home Address:
City and Zip:
Home Phone:
Email Address:
Are you a Brainpower employee? _________ If so, please indicate if mother or father is the employee (circle one)
Recruitment Referral: Referring Family Name: _________________________________________________
LIST CHILDREN REGISTERED FOR 2015-2016
Name (Last, First)
Grade for 2015 - 2016
1.
2.
3.
4.
PAYMENT OPTIONS
Fees
12 Month
Annual
3% Discount
K3
$600.
$5530.
$5364.
K4
$600.
$5530.
$5364.
K5 – 8th
$600.
$4960.
$4811.
Grade Levels
K5 – 8th (Each Additional Child)
$450. (Each)
$3960. (Each)
$3841. (Each)
ALL Tuition, Parish Contributions, Fees, and ASC payments require an automatic draft/credit card form.
Parish Tuition & Fees Payment Agreement 2015-2016
TUITION & FEES PAYMENT AGREEMENT
(Returning Students: I agree to pay $125. at Re-registration in January for each child).
I agree to pay $ __________ for tuition/fees each month for _____ months for the School year 2015-2016
beginning ____________________. I understand that ALL tuition, Parish Contributions, Fees, and ASC
payments require an automatic draft/credit card form. I also understand that any/all NSF Bank Drafts or
Credit Card transactions will result in a $35 fee. I understand that my child can be withdrawn from St.
Peter’s School the first day of the second month that tuition is not paid unless a formal written payment
agreement has been approved by the Principal or designee. I agree to pay After School Care per ASC
Contract on a monthly basis. Other financial obligations (e.g., fines, damaged and/or lost property charge,
etc.) will be paid in a timely manner. ALL Tuition & Fees are Non- Refundable.
Requirements for Parish Tuition: To qualify/maintain Parish (discounted) Tuition Rates:
o Registration and active participation as a member of St. Peter Prince of the Apostles Parish for at
least 3 or more months.
o Stewardship participation is at least $50 per month (July - June), payable through the St. Peter
Prince Church website On-Line Giving tab by bank draft or credit card.
www.stpeterprinceoftheapostles.org
o If regular contributions cease, Parish Tuition payment reverts to St. Peter Prince of Apostles
School Non-Parish Tuition Rate. Membership in the Parish is not affected.
o When a discount for Parish Tuition Rate is selected, the Brainpower discount cannot apply.
______________________________________________
_______________________________
Parent/Guardian Signature
Date
________________________________________
Relationship to student(s)
___________________________________________
Social Security Number of Responsible Party
Parish Tuition & Fees Payment Agreement 2015-2016