2022-2023 Registration
We prefer online registrations . www . isd622 . ce . eleyo . com
Please print clearly
Parent 1 |
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Parent 2 |
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Email |
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Email |
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Address |
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Address |
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City |
ZIP |
City |
ZIP |
Home Phone |
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Home Phone |
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Alternate Phone |
work | cell |
Alternate Phone |
work | cell |
Names of adults attending class |
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Names of children attending class : |
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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 12 , 2022 – Jan 20 , 2023 ) Semester II ( Jan 23 – May 25 , 2023 ) Class number / name # / # /
Class fee ( for first child )
See sliding fee scale on page 6 $ $
Add half the class fee for each additional child attending the same class
$ $
Total tuition $ $
Total payment
Semester I tuition is due with registration * Semester II tuition is due on Jan . 23 , 2023
Payment
□ Check # ( payable to ISD 622 )
□ Visa
□ MasterCard
□ American Express
□ Discover
$ |
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Name on card |
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Card # |
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Exp . date |
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Verification code ( 3 digit ) |
Signature |
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* 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 , 2023 . Please contact the ECFE office for details .
If your class is full , please indicate your second choice class number and name # /
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 .
Office use : Date Registration received : Immunization form complete Census
E C F E
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