The UMD Children's Place Application for Admission is a comprehensive and detailed document that aims to streamline the enrollment process for prospective families seeking childcare services. This form not only captures essential information about the child, such as their name, date of birth, and address, but it also delves into specifics regarding the childcare needs and preferences, including the desired start date and any identified special needs, highlighting the center's inclusive approach. A non-refundable application fee is required to place a child's name on the waiting list, indicating the center's policy to manage demand effectively. Importantly, the application gives precedence to children of UMD faculty, students, and staff, reflecting the institution's commitment to serving its community. Furthermore, it outlines the available enrollment options, which accommodate various schedules but prioritize full-time, full-year enrollment, demonstrating the center's flexibility and understanding of family needs. The form also details financial obligations, including tuition rates, billing cycles, and policies regarding late payments and withdrawal, ensuring families are well informed about their financial commitments. Charges for absences due to illness or vacation, along with potential collection actions for delinquent accounts, are clearly communicated, underscoring the center's expectations for fiscal responsibility. Through this application, UMD Children's Place presents a thorough and transparent overview of its enrollment process, expectations, and offerings, ensuring families can make informed decisions about their childcare needs.
| Question | Answer |
|---|---|
| Form Name | Childrens Place Application Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | childrens place job application, children's place application, the children's place applications, children place job application |
UMD Children’s Place
Application for Admission
Please return this form with the
to add your child’s name to the waiting list (fee is $45 for multiple children)
Child’s Name: _____________________________________ Date of Birth ____________________
*Last |
First |
Middle |
Actual or Anticipated |
*Please print the child’s last name. S/he will be listed by this name.
Address _____________________________________ City ______________________ Zip _______
Does this child have an identified special need *? Yes ____ No ____ |
*UMD Children’s Place is |
|
an inclusive program |
||
|
PREFERRED START DATE ________________________________ Age on start date ________
Please enter a complete date: MONTH |
DAY |
YEAR |
(in months) |
When your child’s name reaches the top of the list, we will call you for any age appropriate opening in the schedule you have indicated on the reverse of this form occurring 30 days prior to or any time after your indicated start date. ***Preference is given to UMD faculty, students and staff.
If you are offered and decline the enrollment date noted above, or the schedule requested on the reverse side of this form, your child’s name will go to the bottom of
the waiting list.
Parent or Guardian 1:
Name____________________________________________________________________________
Address_____________________________City____________________ State ______ Zip_______
Phone numbers: (H)____________________(W)__________________(Cell)___________________
Email address _____________________________________________________________________
Parent or Guardian 2:
Name_____________________________________________________________________________
Address_____________________________City_____________________ State ______ Zip_______
Phone numbers: (H)____________________(W)___________________(Cell)___________________
Email address ______________________________________________________________________
UMD Employee _____ UMD Student _____ No UMD Relationship at this time ____
I (We) understand that this application does not guarantee enrollment in the UMD Children’s Place.
Signed |
Date |
|
|
For office use only: |
Child enrolled ______________________ Child withdrawn __________________________________
260 Kirby Plaza 1208 Kirby Drive Duluth, MN 55812 218.726.6727 FAX 218.726.6654
UMD Children’s Place
Application for Admission
Child’s Name: _____________________ Age Group: Infant____ Toddler____ Preschool____
Enrollment Options ** Please note that enrollment options are for FULL DAYS only and priority is for
Full time
____ |
Full Time (Monday through Friday full days; full year) |
|
____ |
Full Time (Monday through Friday full days; partial year) |
|
|
Care requested from ____________________through __________________ |
|
|
Date |
Date |
|
|
|
____ |
Monday, Wednesday, Friday (Full Days; full year) |
|
____ |
Monday, Wednesday, Friday (Full Days; partial year) |
|
|
Care requested from ____________________through __________________ |
|
|
Date |
Date |
____ |
Tuesday and Thursday (Full Days; full year) |
|
____ |
Tuesday and Thursday (Full Days; partial year) |
|
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Care requested from ____________________through __________________ |
|
|
Date |
Date |
Rates (as of 7/01/12 and subject to change)
Infant Care: |
Monday through Friday |
$210/week |
6 wks – 16 months |
Monday/Wednesday/Friday |
$139/week |
|
Tuesday/Thursday |
$101/week |
Toddler Care: |
Monday through Friday |
$190/week |
(16 mo. – 33 mo.) |
Monday/Wednesday/Friday |
$127/week |
|
Tuesday/Thursday |
$ 93/week |
Monday through Friday |
$185/week |
|
(33 mo. – 1st day K) |
Monday/Wednesday/Friday |
$124/week |
|
Tuesday/Thursday |
$ 91/week |
A 10% discount is given to families with multiple children enrolled.
I/We understand that tuition is billed in four week increments and a statement with due date will be issued. Families receiving childcare assistance are responsible for all charges not paid by the funding source. A late fee of $25 will be applied to any account where payment is not received by the due date. Delinquent accounts will be turned over to a collection agency, and enrollment will be terminated. Accounts in collection will be assessed up to 50% of the balance to cover collection costs. We charge for all absences including illness or vacation. If a child is withdrawn from the program, written notification must be given to the director. Tuition is charged for four weeks following this written notification. Changes to an enrollment schedule will only be made if space is available.
Signed __________________________________________________ Date _______________
Notify us of ANY changes in your enrollment choice. When offered a placement, it is based on this information. If you do not accept the enrollment option offered, your child will go to the bottom of the waiting list. All changes must be submitted in writing.
260 Kirby Plaza 1208 Kirby Drive Duluth, MN 55812 218.726.6727 FAX 218.726.6654