Exceptional Early Childhood - Alexandria, Minnesota School District ...

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Early Education Center Open House from after concert until 11:00 am Bring your own Teddy Bear! Laura Knudsen, Chair laura@lauraknudsen.com Lisa Meichsner, Treasurer wcei@gctel.net Tina Bartone tinabartone@gmail.com Janice Jablonski, Secretary JaniceJ@marykay.com Mariah Wirth, Teacher Contact mdwirth@embarqmail.com Eliza Henrich elizahenrich@gmail.com Bocar Kane kane0162@umn.edu An ECFE Family Event 3:30—5:30 pm Sunday, February 12, 2012 At The Douglas County Library and LAR Gym 6
Send Registration Form and Fee to: Early Childhood Family Education, PO Box 308, Alexandria MN 56308 Spring 2011-2012 Mail-in or drop off registrations Recommended by February 20th, 2012 *Unless you are contacted you are enrolled in class* Parent’s Name________________________________________ Home Phone _______________________ Work Phone _________________ Cell Phone (Mom)_________________ Cell Phone (Dad)_______________ Address __________________________________________________________________________________ E-mail Address: ___________________________________________________________________________ Class # Class Title Name of Child Gender Birthdate Fee ________1st Choice ____________________________ ______________________ M F _____/_____/_______ ________ 2nd Choice Class #_______ Class Title ___________________________ ________1st Choice ____________________________ ______________________ M F _____/_____/_______ ________ 2nd Choice Class #_______ Class Title ___________________________ ________1st Choice ____________________________ ______________________ M F _____/_____/_______ ________ 2nd Choice Class #_______ Class Title ___________________________ Sibling Care Rates for Daytime Classes Only ~ Please include fee when registering. 1 Child - $10 2 Children - $20 3 Children - $30 Class# Name of Child Gender Birthdate Fee ________ _____________________________________________________________ M F _______/______/__________ ________ ________ _____________________________________________________________ M F _______/______/__________ ________ Are you attending for the first time ____ Yes ____ No Suggested Fee Scale Please pay according to your income for 13 weeks of class Under - $20,000 Free $20,000 - $35,000 $39 $35,000 - $50,000 $59 $50,000 - $75,000 $64 Above $75,000 $74 Payments may be made by check or credit card. To pay by credit card, please provide the following: Charge my credit card: ____Master ___Visa ___Discover Card # _______ ______ _______ _______ Exp Date: _______ Amount $______________ Cardholder’s Signature _______________________________________ 7
Page 1 and 2: Exceptional Early Childhood Program
Page 3 and 4: Mondays Tuesdays Wednesdays Thursda
Page 5: About our weekly classes: Parents c

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