Enrollment Application

St. Matthew Lutheran Preschool

           5566 Chambersburg Rd.

           Huber Heights, Ohio 45424

           937-233-4632

Child’s Name_________________________________________________ Date of Birth______________________

Address________________________________________________Telephone______________________________                                  

   

Father’s Name______________________________________________Telephone/Cell #_____________________

         E-Mail Address__________________________________________

Business Name & Address ____________________________________  Work Telephone_____________________         

                                                                               

 

Mother’s Name_______________________________________________Telephone/Cell #___________________

        E-Mail Address_______________________________________

Business Name & Address_______________________________________Work Telephone___________________

                                             

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Please enroll my child for:

______    3 - 5 yr. old class Mon/ Tues/ Wed. 9:00-11:30  a.m.

Please return this form along with a non-refundable registration fee of $30.00 to St. Matthew Lutheran Church Preschool, 5566 Chambersburg Rd., Huber Heights, OH 45424.

The monthly tuition fee for our 3-day program is $100.00. A one-time supply fee of $30.00 will also be asked at the time of the first tuition payment. A tuition reduction of $20.00 per additional child is available when more than one child from one family is enrolled.

 Please feel free to view information about our school on www.stmatthewlutheran45424.com You may contact the director, Karen Schreiber at 233-4632 or 864-5107 Or at stmatthewpreschool@att.net, if you have questions or would like to see our facility.

St. Matthew Lutheran Preschool Does not discriminate because of race, color, gender, and religion or ethnic and national origin.

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