Kindermusik with Jeanneane:: a good beginning never ends

Winter/Spring 2010 Registration & Fees
REGISTRATION FORM for School location Only

You may drop off your Registration form & Deposit at the School or mail it directly to:
Kindermusik with Jeanneane • 162 Lakewoods Ct. • Bloomingdale, IL. 60108
Cash, Money Order or Check Only. Please make checks payable to: Jeanneane Palczewski

Parents Name

Date

Address

City, State & Zip

Home Phone

Emergency Phone

Child’s Name

Date of Birth

Child’s age at start of Semester

Male Female

Bartlett Christian Academy
*Class Name*	*Day/Time*	*Tuition & Materials*
Young Child: Semester 2 Ages 5 1/2 – 6 1/2 yrs.	Tuesday's 6:00 – 7:00 pm	Tuition & Material Total = $215 Cont. Students or Total = $235 New Students
Total Due =

To assure placement for your child I must receive a deposit of $70 along with this registration form or full payment. All deposits are non-refundable. If you choose to pay in full before the first class you will receive a $10 discount. You may pay in two payments also. Half of the tuition by the first class & Half in week 7.

Families with more than one child in my program receive a special discount.
Contact Jeanneane Palczewski for more information.