Miss Lilli’s Registration & Contract

First Semester: 

First Semester:  Sept. 12, 2022 – January 09, 2023

 

Miss Lilli’s Registration & Contract

First Semester:  Sept. 12, 2022 – January 09, 2023

 

Parent/Guardian ________________________________________________                    

Student      _____________________________Date of Birth ____________                       

 Student      _____________________________Date of Birth ____________           

 Student (s) _____________________________Date of Birth ____________                 

 

Address ______________________________________________________         

City/State/Zip   ________________________________________________         

 Home phone   _________________  Cell phone  _____________________               

Parent’s e-mail ________________________________________________                  

 

Circle the names of the classes your children are taking and write each child’s name next to the intended class:                 Charter Price: 

All Things Fun, 60 mins/wk, $250.00 per semester                       Charter Price $275.00 

            Meets Mondays 9:00-10:00

 Bragging Rights, 60 mins/wk, $250.00 per semester.                  Charter Price  $275.00 per semester

Meets Mondays 10:00-11:00

 

Rational Bible, 60 min/wk, $250.00 per semester                        Charter Price:  $275.00 per semester

            Meets Mondays 11:00-12:00

 

 Total class fees for first semester:   ________

Students dropping the course after registration and payment and prior to the start of the course, can expect to receive a refund, minus a $25 administration fee.

Students wishing to drop after the fourth week of class will not receive a refund.

Parents of charter school students are ultimately responsible for the tuition in the event that the charter school refuses to pay.

 

Family Payment Plan spread over 4 months, add $15 billing fee   +____      $15 billing fee

 

Total Due ____________

 

For payment plan:

 

I  _______________________________  (parent’s name) commit to paying:________

 

For a payment plan, divide your total into 4 equal payments.

$________  in September                                          

 

$ ________ in October                                                                                              

$________ in November                                           

$________ in December

 

 

Make all checks payable to:

Lilli Witczak

679 W. Sierra Madre Blvd.

Sierra Madre, CA 91024