St. John’s PreK

Before School Care Sign Up Form

(7:30 am – 8:30 am)

Weekly:  Please register and pay with this form by Thursday of the preceding week.

Monthly:  Please register and pay with this form by the 25^th of the preceding month.

 Child’s Name:  __________________________________    

Month  of: ______________________________________

Please mark each day that your child will be arriving early.

Month ______________________  2010

Monday	Tuesday	Wednesday	Thursday	Friday

                                                  Total Month Hours ______ x $2/hour:    $________

(Office Use Only –   Scheduled ________      Receipt ________)              Date Paid ___________