Registration Form Register online at any time! www.HopkinsSchools.org/Early Hopkins Public Schools ECFE Class registration (Early Childhood Family Education) Mail completed form to: Harley Hopkins Family Center, ECFE, 125 Monroe Ave. S., Hopkins, MN 55343 • Please use one form per child. (Additional forms are available at the Harley Hopkins ECFE office.) • Please include a separate check for each class. Include Sibling Care fees if appropriate. • Questions about how to complete this form? Please call us at 952-988-5000.
Family Information
• Please Print Clearly •
First Parent Name ________________________________________________________________________ q Check if attending class first middle initial last Second Parent Name ______________________________________________________________________ q Check if attending class first middle initial last Child’s Name ____________________________________________________________ Date of Birth___________   q Male    q Female
first
middle initial
last
Address ______________________________________________ City_____________________________ Zip_______________ Phone: Home:________________________ Work ______________________________ Cell ____________________________ Email (print clearly) _______________________________________________________________________________________ Child’s Country of Origin___________________________________________________________________________________ Check here to receive our E-News. q Yes, I would like to receive parenting information, special offers, and promotions from Hopkins Community Education Early Childhood via email. I understand that my email address will not be shared without my permission. Additional Siblings in family: Name _________________________________________________ Date of Birth______________  q Male   q Female first last Name _________________________________________________ Date of Birth______________  q Male       q Female first last
Course Registration Information
Class Title
Class No.
Day(s) Class Meets
Class Time
Class Fee
*Sibling Care Fee
Sub Total
1st Choice ____________________________________ _________ _________ _________ $________ $________ $________ 2nd Choice____________________________________ _________ _________ _________ $________ $________ $________ Topic Class____________________________________ _________ _________ _________ $________ $________ $________ Topic Class____________________________________ _________ _________ _________ $________ $________ $________ *Sibling fee is ½ the class fee TOTAL $________ If your 1st or 2nd choice is not available, please list two alternate class choices: Wait List Class #1: _____________________________________ Wait List Class #2: _________________________________________
Sibling Care Registration Registration is required for Sibling Care. At 6 months of age siblings must attend Sibling Care Name___________________________________________________________ Birthdate ________________ Class No. ________________ Name___________________________________________________________ Birthdate ________________ Class No. ________________ Is your child receiving Early Intervention Services (optional) q Yes If yes, what kinds of intervention services is he/she receiving:
qNo
We are residents of the Hopkins Public Schools District or have already been accepted as an open-enrolled family into this school district. q Yes q No Are you new to Hopkins ECFE?
qYes
q No
How did you find out about ECFE? ___________________________________________________________________________________
Payment Information Make online payments at www.HopkinsCommunityEd.org, or you may pay in person at Harley Hopkins Family Center main office. q Check: Checks payable to ISD 270 Check No.__________________ q Cash: (do not mail cash)_________________ Date ______________
12 Register: www.HopkinsSchools.org/Early • 952-988-5000