School Age Services
Extended Educational Care 2012 - 2013 Registration Form
For Half Day Kindergartners Available at Your Child’s School Extended Educational Care, EEC, is an extended day kindergarten program that allows kindergartners to remain in school for a full day. EEC gives students the opportunity to: • Review lessons from their regular classroom.
United Way funds make it possible for Children, Inc. to keep EEC affordable for families with kindergartners. Families who qualify for Free or Reduced Lunch qualify for significant reductions in tuition. Visit www.childreninc.org and click on “Tuition Assistance” to see if you qualify for state child care assistance and for phone numbers of state intake counselors.
• Master the skills they will need to excel in elementary school. Teachers have either a Bachelor’s degree or 2-3 years direct experience. Children who may struggle to keep up with class progress would benefit from EEC’s additional instruction and reinforcement. Full-time Enrollments Only
Call 859-431-2075 ext. 234 to see if you qualify for United Way child care tuition assistance. Children, Inc. also provides Before and After School care, as well as special programs for professional days, school breaks, snow days and summer.
Register online at www.childreninc.org or complete form on reverse side. Visit our website or call 859-431-2075 for more information.
2012-2013 Extended Educational Care
School Age Services
859-431-2075 · www.childreninc.org
There is a non-refundable $25 registration fee per family, per school year for all Children, Inc. School Age Services. Send the first week’s tuition with registration form by May 31, 2012 and the registration fee is waived.
For children other than kindergartners, fill out the Before and After School Registration Form.
My child also needs care (2 day per week minimum): Select the EEC program in which you would like to enroll your kindergarten child. Full time, M-F only:
Before the start of the school day (Before School Program) ___ Mon ___ Tues ___ Wed ___ Thurs ___ Fri
Children, Inc. Morning EEC Session
After the end of the school day (After School Program) ___ Mon ___ Tues ___ Wed ___ Thurs ___ Fri
Children, Inc. Afternoon EEC Session
EEC- $70/week* Before School- $4.75/day (2 day/week minimum), $23/Week* After School- $10.50/day (2 day/week minimum), $48/week*
School Name
EEC + After School (5 days) = $111/week*
___ Check here if attending Shirley Mann Elementary.
EEC + Before School (5 days) + After School (5 days) = $134/week* * Visit www.childreninc.org and click on “Tuition Assistance” to see if you qualify for state child care assistance and for phone numbers of state intake counselors. Call 859-431-2075 ext. 234 to see if you qualify for United Way child care tuition assistance.
All programs are based on projected enrollment. Adjustments may be made based on site needs.
Start Date
Are you eligible for:
(must be at least 2 full business days from submission)
Child Last
Free Lunch
Reduced Lunch
First
Race
Do you receive state child care assistance?
SS#
Male
Yes No
Female
Birthdate/Age
Primary Mailing Address and Contact Information It is very important you contact us at 895-431-2075 if any of your information changes. Parent/Guardian 1 Last
First
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(
Work Phone
Employer
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Cell Phone
Email
First
Employer
Parent/Guardian 2 Last
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(
Work Phone
)
Cell Phone
Email
Primary Mailing Address House #
Street
City, State Zip
County
(
)
Home Phone
Emergency Contact 1
( Last
First
Last
First
Emergency Contact 2
)
Primary Phone
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Primary Phone
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Secondary Phone
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Secondary Phone
May we give information regarding your child to Parent/Guardian #2? Yes No Is there anything we need to know to better serve your child? (Examples: Special physical or emotional needs, behavioral issues, health concerns or allergies.) If you have any other questions, comments or issues, please enter that information in this field.
I understand that a current Immunization Certificate must accompany this enrollment and agree to provide one during my child's first week of attendance. Return with $25 Registration Fee to: Children, Inc., 333 Madison Ave, Covington, KY 41011 or fax to 859-431-3134.
IMPORTANT: Tuition is due at the beginning of each week. You must pay the enrolled amount, regardless of whether or not school is in session (i.e. snow days, in-service days), with the exceptions of Winter and Spring Breaks. Additional care is typically available on those days that classes are not held. Save all tuition receipts for tax purposes, as a financial statement will not be provided. Please see your parent handbook for further information. (Revised 1/12)
