BCS 3-school and 4-school Online Enrollment Form
Email address *
TUITION & PROGRAM INFORMATION
3-school (Must be 3 by Sept. 1) - Tuesday & Thursday - 9:00 AM - 11:00 AM - $855 Annual Tuition

3-Day PM 4-school (Must be 4 by Sept. 1) - Monday, Wednesday, & Friday - 1:00 PM - 3:30 PM - $1255 Annual Tuition

3-Day AM 4-school (Must be 4 by Sept. 1) - Monday, Wednesday, Friday - 9:00 AM - 11:30 AM - $1255 Annual Tuition
PARENT/GUARDIAN INFORMATION
Parent(s)/Guardians(s) First and Last Name(s): *
Your answer
Address/City/State/Zip *
Your answer
Home Phone/Best Contact Number: *
Your answer
Email Address: *
Your answer
Publish Email Address in School Directory: *
Church Affiliation: *
Your answer
STUDENT #1 INFORMATION
**3-school students must be 3 by September 1, 2020. 4-school students must be 4 by September 1, 2020.
Child's Full Legal Name (First, Middle, Last): *
Your answer
Child's Birthday: *
MM
/
DD
/
YYYY
Gender: *
2020/2021 Program: *
If the AM 4-school Program is at the maximum capacity of 18 students, would you like to be placed on a wait list to get into the AM 4-school Program? *
STUDENT #2 INFORMATION (Only if enrolling multiple students)
**3-school students must be 3 by September 1, 2020. 4-school students must be 4 by September 1, 2020.
Child's Full Legal Name (First, Middle, Last)
Your answer
Child's Birthday:
MM
/
DD
/
YYYY
Gender:
2020/2021 Program:
If the AM 4-school Program is at the maximum capacity of 18 students, would you like to be placed on a wait list to get into the AM 4-school Program?
PHOTO PERMISSION
Borculo Christian School has permission to use photos and digital media of our child(ren) for publication in newsletters, on the school website, and promotional products current and yet to come. Additionally, I/we give consent for the use of digital media and images, including first names, for the purpose of archival media (i.e. end of year memories DVD's, etc). *
FIELD TRIP PERMISSION
*
Required
FERPA Consent
Sharing immunization and personally identifiable information including the students name, Date of Birth, gender, and address with local and state health departments will help to keep your child safe from vaccine preventable diseases. The Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. § 1232g, requires written parental consent before personally identifiable information from your child’s education records is disclosed to the health department. If your child is 18 or over, he or she is an “eligible student” and must provide consent for disclosures of information from his or her education records.
I authorize Borculo Christian School to release my child’s immunization record to the Michigan Department of Health and Human Services and Local Health Department. I understand this information will be used to improve the quality and timeliness of immunization services and to help schools comply with Michigan Law. This includes any immunization information and limited personally identifiable information from the school.
Borculo Christian 3-school and 4-school programs both require a parent/guardian to help provide snacks and assist in the classroom once every 6-8 weeks. The teacher will advise parents when help is needed.
Emergency Information
Father's Employer: *
Your answer
Father's Work # *
Your answer
Father's Cell #: *
Your answer
Mother's Employer: *
Your answer
Mother's Work #: *
Your answer
Mother's Cell #: *
Your answer
Emergency Contact #1: *
Your answer
Emergency Contact Phone #: *
Your answer
Emergency Contact #2: *
Your answer
Emergency Contact Phone #: *
Your answer
Emergency Contact #3: *
Your answer
Emergency Contact Phone #: *
Your answer
Does your child(ren) have any allergies the school should be aware of? *
If yes, please list the allergies and special instructions:
Your answer
Do you give the school permission to give Tylenol (generic brand) to your child(ren)? *
Name of Child's Physician: *
Your answer
Name of Child's Health Clinic: *
Your answer
Phone # of Child's Health Clinic: *
Your answer
Please describe any health information you feel would be important for the school to know about: *
Your answer
Please describe any behavioral concerns you feel would be important for our school staff to know about: *
Your answer
Please describe any educational concerns you feel would be important for our school staff to know about: *
Your answer
Please describe any other concerns about your child(ren) you feel would be important for our school staff to know about: *
Your answer
Borculo Christian School Enrollment Contract Terms
It is necessary to establish an agreement upon payments made for tuition and that families adhere to the agreed-upon payment schedule. The board must meet its monthly payments and therefore this necessitates each family doing the same.

1. I/We agree to make full payment of any prior commitment by June 1, 2020. If unable to do so, I will request a meeting with the school’s Finance Committee to mutually resolve the matter. Until these criteria are met, enrollment of the new school year is considered conditional.
2. If I/We cannot meet the payment plan, I/We will contact the Finance Committee.
3. I/We understand that in the event tuition is not paid, legal means of tuition collection may be used.
4. Any child shall be permitted to enroll whose tuition is paid from the previous year. If a balance remains, however, there must be a written agreement as to the tuition payment for the current year.
5. Families that no longer have children at Borculo Christian School are expected to have their tuition paid in full at the time of leaving Borculo Christian, the family and the finance committee must agree on a payment plan to pay the remaining amount owed to BCS. This plan will be made in writing and signed by the parent or parents and a representative of Borculo Christian School.
*
Required
*$50 non-refundable deposit due at enrollment. Deposit holds your spot and is credited towards your tuition.
Parent/Guardian Signature: *
Your answer
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