School Registration and Pricing 2010-2011

• Your Name*
  First Name

  Last Name
• Your Email*
   
• Mailing Address*
  Street Address*

  Address Line 2

  City*

  State / Province / Region*

  Zip / Post Code

  Antigua and BarbudaBahamasBarbadosBelizeCanadaCosta RicaCubaDominicaDominican RepublicEl SalvadorGrenadaGuatemalaHaitiHondurasJamaicaMexicoNicaraguaPanamaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesTrinidad and TobagoUnited StatesArgentinaBoliviaBrazilChileColumbiaEcuadorGuyanaParaguayPeruSurinameUruguayVenezuelaAlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandItalyLatviaLiechtensteinLithuaniaLuxembourgMacedoniaMaltaMoldovaMonacoMontenegroNetherlandsNorwayPolandPortugalRomaniaSan MarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandUkraineUnited KingdomVatican CityAfghanistanBahrainBangladeshBhutanBrunei DarussalamMyanmarCambodiaChinaEast TimorIndiaIndonesiaIranIraqIsraelJapanJordanKazakhstanNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLebanonMalaysiaMaldivesMongoliaNepalOmanPakistanPhilippinesQatarRussiaSaudi ArabiaSingaporeSri LankaSyriaTaiwanTajikistanThailandTurkeyTurkmenistanUnited Arab EmiratesUzbekistanVietnamYemenAustraliaFijiKiribatiMarshall IslandsMicronesiaNauruNew ZealandPalauPapua New GuineaSamoaSolomon IslandsTongaTuvaluVanuatuAlgeriaAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeCentral African RepublicChadComorosCongoDjiboutiEgyptEquatorial GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauCôte d\'IvoireKenyaLesothoLiberiaLibyaMadagascarMalawiMaliMauritaniaMauritiusMoroccoMozambiqueNamibiaNigerNigeriaRwandaSao Tome and PrincipeSenegalSeychellesSierra LeoneSomaliaSouth AfricaSudanSwazilandTanzaniaTogoTunisiaUgandaZambiaZimbabwe

  Country*
• Phone*
   

  (###)

  -

  ###

  -

  ####
• How did you hear about us?*
  TV Ad

  Postcard

  Sign on Freeway

  Mail / Newspaper

  Friend

  Web Search
• How many children will be attending?*
  >123More than 3
• Please list the name, grade, and age of each child.
  Child's name, grade, age
• Information Only / Application*
  >Send Information OnlyComplete Application
• Application For Enrollment
• Student Lives with:*
  Father

  Mother

  Step Father

  Step Mother

  Other
• Father/Guardian*
  First Name

  Last Name
• Marital Status*
  Married

  Divorced

  Single

  Sperated

  Widowed
• Work Phone*
   
• Cell Phone*
   
• Mother/Guardian*
  First Name

  Last Name
• Marital Status*
  Married

  Divorced

  Single

  Sperated

  Widowed
• Work Phone*
   

  (###)

  -

  ###

  -

  ####
• Cell Phone*
   

  (###)

  -

  ###

  -

  ####
• School Last Attended*
• Address of School Last Attended*
  Street Address*

  Address Line 2

  City*

  State / Province / Region*

  Zip / Post Code

  Antigua and BarbudaBahamasBarbadosBelizeCanadaCosta RicaCubaDominicaDominican RepublicEl SalvadorGrenadaGuatemalaHaitiHondurasJamaicaMexicoNicaraguaPanamaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesTrinidad and TobagoUnited StatesArgentinaBoliviaBrazilChileColumbiaEcuadorGuyanaParaguayPeruSurinameUruguayVenezuelaAlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandItalyLatviaLiechtensteinLithuaniaLuxembourgMacedoniaMaltaMoldovaMonacoMontenegroNetherlandsNorwayPolandPortugalRomaniaSan MarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandUkraineUnited KingdomVatican CityAfghanistanBahrainBangladeshBhutanBrunei DarussalamMyanmarCambodiaChinaEast TimorIndiaIndonesiaIranIraqIsraelJapanJordanKazakhstanNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLebanonMalaysiaMaldivesMongoliaNepalOmanPakistanPhilippinesQatarRussiaSaudi ArabiaSingaporeSri LankaSyriaTaiwanTajikistanThailandTurkeyTurkmenistanUnited Arab EmiratesUzbekistanVietnamYemenAustraliaFijiKiribatiMarshall IslandsMicronesiaNauruNew ZealandPalauPapua New GuineaSamoaSolomon IslandsTongaTuvaluVanuatuAlgeriaAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeCentral African RepublicChadComorosCongoDjiboutiEgyptEquatorial GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauCôte d\'IvoireKenyaLesothoLiberiaLibyaMadagascarMalawiMaliMauritaniaMauritiusMoroccoMozambiqueNamibiaNigerNigeriaRwandaSao Tome and PrincipeSenegalSeychellesSierra LeoneSomaliaSouth AfricaSudanSwazilandTanzaniaTogoTunisiaUgandaZambiaZimbabwe

  Country*
• Phone of School Last Attended*
   

  (###)

  -

  ###

  -

  ####
• Fax of School Last Attended
   

  (###)

  -

  ###

  -

  ####
• Students Grades Have Been:
  >Above AverageAverageBelow Average
• Has the Student Ever Repeated a Grade:
  >YesNo
• Enter Grade Repeated
• Has Student Been Expelled, Suspended, or Asked to Withdraw*
  >YesNo
• Please Explain:
• Are there any special factors, conditions, learning disabilities, including any special medications or allergies, affecting the applicant:*
  >YesNo
• Please Explain:
• Church Currently Attending:*
• * If your home church is not Foothill Baptist Church, please attach a letter of recommendation from your Pastor on church letterhead.
   
• Please indicate below if after school care is needed:*
  Kindergarten After School Care 12:30 - 3:30 $100 per month

  After School Care 3:30-4:30 $70 per month

  After School Care 3:30-5:30 $140 per month

  Not Required
• Please note that this form is subject to approval by the Principal. A completed Emergency card and registration payment must be added to this form before enrollment is complete.