Returning Student Application 2022-2023

Class

3/4 “Rockets” Class (T/Th 9:30 – 1:00) Tuition: $280/month plus One-Time Supply and Field Trip Fee $60

Pre-K “Explorers” Class (M/W/F 9:30 – 1:00) Tuition: $320/month plus One-Time Supply and Field Trip Fee $75

Child's Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Age

Birthday

YYYY

Family Email Address You Check

Parent/Guardian 1 Name

First Name

Last Name

Parent/Guardian 1 Cell Phone

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Parent/Guardian 1 Email

Parent/Guardian 2 Name

First Name

Last Name

Parent/Guardian 2 Cell Phone

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Parent/Guardian 2 Email

Church Affiliation

I learned about Holy Spirit Preschool from

Upon receipt of this form and the $100 non-refundable application fee (mail to or drop off at Holy Spirit Lutheran, 10021 NE 124th St, Kirkland, WA 98034), your child’s name is placed on our registration list. By March 15, we will contact you to confirm your spot in the class or let you know where you are on the wait list.