Early Childhood Family Education 2020-2021 Catalog | Page 2

2020-2021
E C F E
Registration
We prefer online registrations. We encourage you to visit www.isd622.ce.eleyo.com
Please print clearly
Parent 1 Parent 2
Email Email
Address Address
City
ZIP
City
Home Phone
ZIP
Home Phone
Alternate Phone
work | cell
Alternate Phone
work | cell
Names of adults attending class
Names of children attending class:
Child 1 Birthdate Sex: M | F Allergies, special needs, etc
Child 2 Birthdate Sex: M | F Allergies, special needs, etc
Child 3 Birthdate Sex: M | F Allergies, special needs, etc
Semester I (Sept 8–Dec 22, 2020)
Class number / name #
Semester II (Jan 4–May 21, 2021)
/
#
Class fee (for first child) $ $
Add half the class fee for each additional
$
child attending the same class $
Sibling Care fee $ $
Total tuition $ $
See sliding fee scale on page 14
* Monthly payment will be accepted for the Parent-Child
Preschool Class (Fee A). The first month’s payment is due at
time of registration. The remaining payments will be due the
first of each month through April 1, 2021. Please contact the
ECFE office for details.
Total payment $
Semester I tuition is due with registration.*
Semester II tuition is due on Dec. 22, 2020 .
Payment
□ Cash
□ Check #
□ Visa
□ MasterCard
/
Name on card
(payable to ISD 622)
Signature
Card #
Exp. date
/
Verification code (3 digit)
If your class is full, please indicate your second choice class number and name #
/
Are you interested in joining the District 622 Early Childhood Advisory Council? □ Yes □ No
Note: Registration is not complete without immunization record and payment.
Immunization records can be faxed directly from your clinic to the ECFE office at 651-702-8496.
13
E C F E
Office use:
Date Registration received:
Immunization form complete
Census
Advisory Council
651-702-8411 (651-788-3664 Español)