Re-Enrollment Application for 2020-2021
First Lutheran Church & School
First Lutheran Church 580-762-1111
1104 N. 4th Street – Ponca City, OK 74601
Principal David Birnbaum 580-762-9950
“GROW at FIRST”
School Fax: 580-762-4243
www.flcspc.com or www.flcspc.org
lutheransecretary@yahoo.com
Please complete the following information.
Student Name:
Check if new address or cell number
Student Name:
Parent / Guardian Name: _____________________________
Student Name:
Address: __________________________________________
Student Name:
City/State/Zip: _____________________________________
Student Name:
Cell #: ___________________________________________ Pre-School 3-year old has the option of Full Day (age 3 by 9/1/20) or Half Day programs.
Pre-Kindergarten 4-year old has the option of Full Day (age 4 by 9/1/20) or Half Day programs.
Space is limited.
Space is limited.
Child’s birth date:______________________
Child’s birth date:______________________
Full-Day _____ 8:20 – 3:10
Full-Day _____ 8:20 – 3:10
Half-Day _____ 8:20 – 11:00
Half-Day _____ 8:20 – 11:00
To reserve a place, 1/3 of the enrollment fee must be paid with this form and all paid by April 30. Infant thru Pre-K 4 Kindergarten thru 5th Grade Grades 6th – 8th
Enrollment Fee Free $450.00 $495.00
Discount rate if paid by April 30 ($360 if paid in full by April 30) ($435 if paid in full by April 30)
Referral Credit: $200 CREDIT to ANY current school family for each NEW family to our school that enrolls in grades 1 – 6 that states on their application that they were referred to us by that family. The current school family will receive the $200 credit in January for each of those new families with students in 1st – 6th grade that remain enrolled through the first semester. There are multiple discounts available. Please review the financial page and tell us which tuition payment plan you intend to use.
Payment Plan Options:
1 Payment
2 Payment
9 months
12 months (starts in June)
Member
Your Signature ___________________________ Print Name _________________________ Date _________________
Growing up, Reaching Out, and Walking together with Jesus at First Lutheran Church & School. “Like new born babies, crave pure spiritual milk, so that by it you may grow up in your salvation, now that you have tasted that the Lord is good.” 1 Peter 2:2-3