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 $2.50/hour: $________

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