Download - Re enrollment application 16 17
Pastor Jeremy May
580 - 762 - 1111 Principal David Birnbaum
580 - 762 - 9950
School Fax 580-762-4243
Student Name:
Student Name:
Student Name:
Student Name:
Student Name:
First Lutheran Church & School
1104 N. 4th St—Ponca City, OK 74601
“Grow at First”
Growing up, Reaching Out, and Walking together with Jesus at First Lutheran Church & School.
First Lutheran’s 90th Anniversary Year Theme Verse (1925-2015)
Lord, you have been our dwelling place throughout all generations. Psalm 90:1
All students must re-enroll annually. Students now attending First Lutheran will receive priority through Feb. 29.
New applications will be considered on March 1. A payment plan is available (1/3 due immediately, 1/3 due
March 31, and final payment by April 30). A portion of the enrollment fee is refundable when cancellation is
necessary: 60% if requested before June 1; 40% from June 1 to August 1. ***No refunds after August 1***
To reserve a place, 1/3 of the enrollment fee must be paid with his form and all paid by April 30.
Enrollment Fee Discount rate if paid by April 30
Pre-School & Pre-Kindergarten (Half days) $250.00 ($200 if paid in full by April 30)
Pre-School & Pre-Kindergarten (Full School days) $350.00 ($300 if paid in full by April 30)
Kindergarten thru 5th grade $350.00 ($300 if paid in full by April 30)
Grades 6th – 8th $450.00 ($400 if paid in full by April 30)
NEW Referral Credit: $200 credit to ANY current school family for each new family to our
school that enrolls in grades 1st – 5th that states on their application that they were referred to
by that family. The current school family will receive the $200 credit in January for each of
those new students in 1st-5th grade that remain enrolled through the first semester.
Re—Enrollment Application for 2016/17
www.flcspc.com www.flspc.org [email protected]
Please complete the following information.
□ Check if new address or cell number
Parent / Guardian Name: __________________________
Address: _______________________________________
City/State/Zip ___________________________________
Cell #: ________________________________________
There are multiple discounts available. Please review the financial page and tell us which tuition payment plan you intend to use.
Payment Plan Options: □ 1 Payment □ 2 Payment □ 9 months □ 12 months (starts in June) □ Member
Your Signature ______________________ Print Name ______________________ Date_____________
Pre-Kindergarten has the option of Full Day
(age 4 by 9/1/16) or Half Day programs.
Space is limited.
Mrs. Kelly’s Full-Day ____ 8:20-3:10
Mrs. Flaherty’s Half-Day ____8:20-11:00
(Mornings only)
Pre-School 3-year old has the option of Full Day
(age 3 by 9/1/16) or Half Day programs.
Space is limited.
Ms. Lester’s Full-Day ____ 8:20-3:10
Mrs. Herard’s Half-Day ____8:20-11:00
(Mornings only)
