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Program Info SCHOOL YEAR 2024-2025 TUITION RATES Ages Days Hours Fees Registration Fee (non-refundable) Toddler class - 12 to 23 Months Monday - Friday 8:30 am - 12:30 pm $12,100 $500 Toddler class - 12 to 23 Months Monday - Friday 8:30 am - 3:30 pm* $13,750 $500 Class of the 2’s Monday - Friday 8:30 am - 12:30 pm $11,100 $500 Class of the 2’s Monday - Friday 8:30 am - 3:30 pm* $13,250 $500 Class of the 3’s Monday - Friday 8:30 am - 3:30 pm* $13,000 $500 Pre-Kindergarten Monday - Friday 8:30 am - 3:30 pm* $13,000 $500 Non-refundable Security Fee - $750 Lunch - $160 a month Nap Pack - $40 *Friday dismissal 2:30pm Child Information Child 1 Full Name* First Name Last Name School Year Program* Toddler class – up to 23 Months (8:30 am - 12:30 pm)Toddler class - up to 23 Months (8:30 - 3:30 pm)Class of the 2's (8:30 am - 12:30 pm)Class of the 2's (8:30 am - 3:30 pm)Class of the 3's (8:30 am - 3:30 pm)Pre Kindergarten (8:30 am - 3:30 pm) Are there any changes to your household info previously submitted?* NoYes Please specify * Medical information Does your child have any allergies or special medical considerations?* NoYes Please state child's allergies or medical problems* Are there any conditions or behaviors requiring special attention or medication?* NoYes Please explain* Has your child ever been hospitalized or had a serious illness?* NoYes Please explain* Do you have any developmental or behavioral concerns regarding your child?* NoYes Please explain* Has your child ever been evaluated for developmental delays or has an evaluation been recommended in the past?* NoYes Please explain* Add a child Child 2 Yes School Year Program* Toddler class – up to 23 Months (8:30 am - 12:30 pm)Toddler class - up to 23 Months (8:30 am - 3:30 pm)Class of the 2's (8:30 am - 12:30 pm)Class of the 2's (8:30 am - 3:30 pm)Class of the 3's (8:30 am - 3:30 pm)Pre Kindergarten (8:30 am - 3:30 pm) Full Name* First Name Last Name What would you like your child to be called?* Hebrew Name * Date of Birth* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Place of Birth * Gender * Male Female Previous School or Day Care Center* Languages Spoken at Home* Medical information Does your child have any allergies or special medical considerations?* NoYes Allergies or medical problems* Are there any conditions or behaviors requiring special attention or medication?* NoYes Please explain* Has your child ever been hospitalized or had a serious illness?* NoYes Please explain* Do you have any developmental or behavioral concerns regarding your child?* NoYes Please explain* Has your child ever been evaluated for developmental delays or has an evaluation been recommended in the past?* NoYes Please explain* Program Information Medical / Authorization EMERGENCY ALTERNATE CONTACTSPlease list two contacts who will take responsibility for your child/ren, in an emergency situation, when neither parent can be reached.Contact 1 Full Name* First Name Last Name Relationship to children* Phone Number* Area Code Phone Number Contact 2 Full Name* First Name Last Name Relationship to children* Phone Number* Area Code Phone Number FAMILY DOCTOR If parents cannot be reached and emergency medical advice is needed, permission is given to the preschool staff to phone your family doctor. Please check* I authorize MJP to contact our family doctor. Full Name* First Name Last Name Address* Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Phone Number* Area Code Phone Number EMERGENCY CARE AUTHORIZATION In case of a medical emergency requiring immediate emergency care (G-d forbid), and none of the people mentioned above can be contacted, I hereby give Midtown Jewish Preschool permission to treat and transport my child/ren to the nearest hospital necessary by ambulance. Parents signature* INSURANCE INFORMATION Name of Insurance policy* AUTHORIZATION FOR PICKUP I authorize the following people (ie: grandparents, nanny) to pick up my children from school on a regular basis. (For pickup on a one time occasion, email [email protected] to notify the office). Please send an ID of each person listed below other than the children's parents to [email protected]. Full Name* First Name Last Name Relationship to children* ADDITIONAL INFORMATION Midtown Jewish Preschool is open Monday through Friday. Our program hours are from 8:30 am to 3:30 pm for full day students and 8:30 am to 12:30 pm for half-day students. Friday dismissal is at 2.30 pm Please be prompt to pick up your child. Please check* I agree to and understand the above operation hours. I hereby give MJP permission to photograph and videotape my child while in school and share these photos & videos in the preschool newsletters, print materials, website and social media. Please check* I give permission to photograph and videotape my child for the above purposes. I give permission for our name and telephone number to be placed on a class list for release to other parents. Please check* I agree for our information to be included in the list and shared to other parents. My child may participate in birthday parties, holiday programs, and any other activities/ programming in which special food is served from outside or prepared in school. Please check* I agree to and understand the outside food policy. Your child will partake in indoor and outdoor physical activity during the course of the day. The children enjoy obstacle courses, balancing equipment, ball play, age appropriate bicycles. Please send your child with appropriate clothing for the weather. Children are to wear closed toe, supportive shoes. No flip flops or open back shoes allowed. When we experience inclement weather, we will partake in indoor gross motor play in our activity room. Children will be encouraged, but never forced, to participate in the physical activities. Please check* I understand that there will be physical activity involved, and our child should be in appropriate clothing for the weather. Parent Handbook . Parent Handbook Please check* I have read the Parent Handbook, and understand and agree to all its contents. PAYMENT INFORMATION Tuition Payment Terms Registration is not complete until all documents are submitted and an email acceptance has been received. By signing this 2024-2025 tuition contract you are financially obligated to the above rates and the MJP terms and conditions. The yearly tuition can be paid in full by July 15th (A 5% discount will be applied to a fully paid tuition by July 15th). Tuition can be paid in 10 installments starting on July 15th through April 15th. All financial information must be submitted by July 15. All MJP payments will be done through an electronic check (aka ACH payments). For any credit card payment, there will be a 3% CC processing fee. For children registering after the beginning of the school year; students enrolling between the 1st - 15th of any month will be required to pay one-half month's tuition at the start. Students enrolling between the 15th – 1st of the month will pay the full month's tuition at the start. A $40 late fee will be charged to any account with a 3-day late payment, whether you receive a statement or not. A $40 charge will be added to any account for each returned payment for any reason. There is no tuition adjustments or credit given for holidays, family vacations or illness. If it becomes necessary to withdraw a student(s) from MJP; the parent or responsible party of the child must notify MJP in writing. MJP will charge an extra month tuition after the child’s withdrawal. Please check* I agree to and understand the above payment terms. E-Check Payment Information (for credit card payment please select below - a 3% CC processing fee will be added to all payments) Account Name* Bank Name* Routing Number* Account Number* Account Type* CheckingSavingsBusiness I authorize MJP to charge my checking/savings account entered above for the non-refundable registration and security fee, and all school fees including yearly tuition and lunch. Please check* I authorize MJP to charge these fees. Upon submitting this form, I authorize MJP to charge my checking/savings account the non-refundable fees: $500 Registration fee and $750 Security fee. No. of children* 12 Please check* I authorize MJP to charge my checking/savings account the non-refundable registration and security fees. Recurring ACH Payment Authorization You authorize regularly scheduled charges to your checking/savings account submitted above.You will be charged the lunch and tuition fees, each billing period. A receipt for each payment will be provided to you and the charge will appear on your bank statement as an "ACH Debit". You agree that no prior notification will be provided before the charge. It is your responsibility to provide us with new information shall this needs to be changed for any reason(s). Please check* I authorize MJP to charge my checking/savings account for the regulary scheduled charges. Other payment method* NoI’d like to pay all school fees and tuition by Credit Card Credit Card Payment Information I authorize MJP to charge my credit card entered below for the non-refundable registration and security fee, and all school fees including yearly tuition and lunch. Please check* I authorize MJP to charge my credit card these fees. Recurring Credit Card Payment Authorization You authorize regularly scheduled charges to your credit card account submitted below. You will be charged the lunch and tuition fees, each billing period. A receipt for each payment will be provided to you and the charge will appear on your bank statement as an "ACH Debit". You agree that no prior notification will be provided before the charge. It is your responsibility to provide us with new information shall this needs to be changed for any reason(s). Please check* I authorize MJP to charge my credit card the regularly scheduled charges. I authorize MJP to charge my credit card entered below the 3% processing fee on all MJP related payments. Please check* I authorize MJP to charge my credit card the 3% processing fee. Upon submitting this form, I authorize MJP to charge my credit card the non-refundable fees: $500 Registration fee and $750 Security fee. No. of children* 12 Please check* I authorize MJP to charge my credit card the non-refundable registration and security fees. Total amount $0.00 Payment* Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2024202520262027202820292030203120322033 Expiration YearBilling Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Mother's signature * Today’s date* Month Day Year Father's signature * Today’s date* Month Day Year Should be Empty: This page uses TLS encryption to keep your data secure.