Culpeper UMC Preschool

CUMC HOMEPAGE

ABOUT US

APPLICATION FOR ADMISSION

You may download a paper Application for Admission by clicking here. Please return this application with a non-refundable enrollment fee of $75.00. (Early Bird Enrollment, $60.00 (Feb 1-Mar 7); Late Enrollment, $80.00 (After May 31). Check are payable to Culpeper United Methodist Church and attach it to this form.
Or, you may register directly online by filling out the following form. When you click submit, you will be directed to our online bill pay where you can remit payment for the registration fee.
Culpeper UMC Preschool does not discriminate against any student on the basis of race, creed, or national origin.

Child Enrollment/ Information Record

First Name

Date of Birth

Child's Middle Name

Gender

Last Name

Child's T-Shirt Size

Please check desired program (student must be age of desired class by September 30, of the current year, and potty trained.)

3 Day Three Year Old Program (Monday, Wednesday, Friday, 9:00am—12:00pm) $325.00 per month

5 Day Three Year Old Program (Monday - Friday, 9:00am—12:00pm) $490.00 per month

3 Day Four Year Old Program (Monday, Wednesday, Friday, 9:00am—12:00pm) $325.00 per month

5 Day Four Year Old Program (Monday - Friday, 9:00am—12:00pm) $490.00 per month

Extended Care, 3 Days Per Week (Monday, Wednesday, Friday, 7:00-9:00am, 12:00-5:30pm) $175.00 per month

Extended Care, 5 Days Per Week (Monday - Friday, 7:00-9:00am, 12:00-5:30pm) $200.00 per month

Child's Home Address/ Contact Information

Child's Home Address

Phone

Email - Primary

Parent/Guardian Information

Email - Secondary

Mother's Name

Home Phone

Cell Phone

Address (if Different than above)

Employer

Father's Name

Home Phone

Work Phone

Cell Phone

Address (if Different than above)

Employer

Work Phone

Medical Information

Child's Physician

Child's Dentist

Phone Number

List all allergies, including food and medical

Any chronic physical and/or emotional problems or conditions

Emergency Contacts (local contacts only, please) If parents/guardians can not be reached

Name

Address

Name

Address

Relationship

Phone

Relationship

Phone

Name and Phone Numbers of persons authorized to pick up your child

(may be the same names as above)

Name

Relation

Other Preschools your child has attended

Phone

Has your child ever been asked to leave a preschool?

Does your child have any special behavior issues?

Are you a member of CUMC?

How did you hear about CUMC Preschool?

Important Information for Parents

Enrollment Policy Children who are enrolled but not toilet trained at the start of school will not be accepted. ENROLLMENT FEES WILL NOT BE REFUNDED IF YOUR CHILD IS NOT TOILET TRAINED. At parents’ request, we can place the child on a waiting list at no cost. The only time a refund of the enrollment fee can be given is if the class is full. Your check will be returned to you.

APPLICATION FOR ADMISSION

Child Enrollment/ Information Record

Child's Home Address/ Contact Information

Parent/Guardian Information

Medical Information

Emergency Contacts (local contacts only, please) If parents/guardians can not be reached

Name and Phone Numbers of persons authorized to pick up your child

(may be the same names as above)

Important Information for Parents

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Tuition Policy The school year’s tuition is based on a yearly rate and is collected in