Laurel Education Center Inc

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Admissions to The Laurel School

Please read our Application Process Document on our school website for more information and deadlines regarding the application process. If you have any questions, please feel free to email Courtney Mills, Director of Operations and Admissions at office@laurel-school.org. After we have received your online application, you will receive an acceptance letter along with the remaining enrollment documents.

REGISTRATION

NEW STUDENT - Non-refundable Registration Fee

$75.00

There will be an additional 3.0% credit card convenience fee added to the total amount.

RE-ENROLLING STUDENTS - No Registration Fee Applicable

Total: $0.00

PROGRAM/SCHEDULE

GRADE ENTERING: *

Please choose your preferred schedule

From 2 to 5 days a week.
Please note that this doesn’t guarantee days or a specific classroom. You will receive confirmation at a later time.

Mondays

Tuesdays

Wednesdays

Thursdays

Fridays

What date would you like to begin enrollment? *

APPLICANT INFORMATION

Child’s First Name: *

Child’s Last Name: *

Child’s Middle Name:

Gender: *

DATE OF BIRTH: *

AGE: *

Race:

Child’ Primary Language, if other than English:

Hair Color: *

Eye Color: *

Identifying Marks:

Does child live with both parents?

If no, which parent does child live with?

Legal custody arrangements or court orders? *

If Yes, please supply latest order with enrollment agreement.

FAMILY INFORMATION

Parent 1/Guardian Full Name:

Physical home address: *

City/State/Zip Code: *

Mailing Address:

(if different from above)

City/State/Zip Code:

Phone 1: *

Please put best number to reach you at in order.

Phone 2: *

Phone 3: *

E-mail Address: *

Parent 2/Guardian Full Name:

Check here if same address as above?

Physical home address:

City/State/Zip Code:

Mailing Address:

City/State/Zip Code:

Phone 1:

Please put best number to reach you at in order.

Phone 2:

Phone 3:

Email address:

Sibling Full Name:

Age:

School:

Sibling Full Name:

Age:

School:

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone: *

E-mail: *

A receipt will be e-mailed to this address.

Comments/Questions:

Please complete your credit card information ONLY if this is a NEW student.

Your Payment Information

Name on Card:

Card Number:

Security Code:

Expiration Date: