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Piper Preschool | 2022-2023 Enrollment
Child's First Name
(Required)
Child's Last Name
(Required)
Child's Date of Birth
(Required)
MM slash DD slash YYYY
Child's Gender
(Required)
Male
Female
Parent A First Name
(Required)
Parent A Last Name
(Required)
Parent A Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Parent A Phone
(Required)
Parent A Email
(Required)
Enter Email
Once more for the people in the back.
Is there another parent in the picture?
(Required)
Yes
No
Parent B First Name
Parent B Last Name
Parent B Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Parent B Email
Enter Email
Once more for the people in the back.
Parent B Phone
Policies and Agreements
Program Enrollment
(Required)
I accept Piper's offer to enroll my child in Piper Preschool for the 22-23 school year.
Enrollment Schedule & Tuition
(Required)
By checking the box(es) below, I am enrolling my child in the following schedule:
9am-12pm | $1200 per month
Payment Plan
(Required)
$1200 due on the first of each month, from June 1, 2023 - July 1, 2023.
Payment Plan Policy
(Required)
By checking this box, I understand that my child's tuition payments, in accordance with my Enrollment Schedule & Tuition selection(s), will be automatically deducted on the 1st of each month. I understand I am required to keep a bank account or credit card on file, and that credit card payments will incur a 3% convenience fee.
Tuition Agreement
(Required)
By checking this box, I understand that tuition is continuous throughout the school year, and that my Payment Plan represents an annual commitment. I understand that my obligation to pay tuition for the entire school year is unconditional, and that no portion of tuition and fees, be it paid or outstanding, will be refunded nor canceled. I understand that the timing of payments is not associated with my child’s time of attendance, and there is no reduction in fees for absences, vacations, holidays, or school closures.
Late Payment Policy
(Required)
By checking this box, I understand that any payment not received by the due date outlined in my Payment Plan, as well as any declined payment, will incur a $100 fee. I understand that any returned check or returned bank debit transaction will result in an additional $25 fee. I understand that, should any balance remain outstanding after 90 days of the original due date, Piper Preschool has the right to discontinue enrollment.
Late Pick-Up Policy
(Required)
By checking this box, I understand that my child’s schedule is set forth in my Enrollment Schedule & Tuition section. I understand that if I am not enrolled in Early Care and/or Extended Care, a fee of $20/hour for coverage outside of my child’s enrolled hours will be added to my monthly payment withdrawal. I understand that a $60 late pick-up fee will be added to my account if my child is picked up after 5:30pm.
Withdrawal Policy
(Required)
By checking this box, I understand that I may request to be released from this contract with a 60-day written notice to the Director. I understand that my notice of withdrawal must be submitted by the 25th of the month for the notice to apply to that month. For example: (1) Notice is given January 25th. You will be charged February and your deposit will apply to March. (2) Notice is given January 26th. You will be charged February and March, and your deposit will be applied to April.
Code of Conduct
(Required)
By checking this box, I understand that Piper Preschool reserves the right to discontinue enrollment in the event of a breach of this agreement and/or failure to adhere to the Parent Code of Conduct, as outlined in the Parent Handbook.
Enrollment Completion
(Required)
Checking this box, signing below, and submitting my deposit signifies that I have read, understand, and agree to all terms and policies listed throughout this complete contract. I have viewed and agree to the School Calendar and Parent Handbook, and understand that Piper reserves the right to make changes.
Enrollment Fee
The Enrollment Fee of $2,000 includes the tuition of $1200 for attendance in May, plus an $800 registration fee. The Enrollment Fee is non-refundable. Select payment method below; if selecting bank transfer, an invoice will be sent upon contract submittal.
Check
Bank Transfer
Signature