Registration Payment

Parent #1 Name(Required)

First Last

Parent #2 Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

How many children are you registering for?(Required)

Please enter a number from 1 to 5.

Child #1 Name(Required)

Birthday(Required)

Grade Entering(Required)

Gender(Required)

Child #2 Name(Required)

Birthday(Required)

Grade Entering(Required)

Gender(Required)

Child #3 Name(Required)

Birthday(Required)

Grade Entering(Required)

Gender(Required)

Child #4 Name(Required)

Birthday(Required)

Grade Entering(Required)

Gender(Required)

Child #5 Name(Required)

Birthday(Required)

Grade Entering(Required)

Gender(Required)

1. Tuition per child K-8 will be about $14,500-$15,000 per a child. FEES ARE ON AN ANNUAL BASIS.
2. A non-refundable registration fee of $375 per child is required at the time of registration.
3. It is understood that no adjustment will be made in any of the above fees because of a child’s absence from school.
4. No assignment of classes will be made without this signed Registration Form on file.
5. These amounts are not finalized and subject to change by the Board of Trustees.
6. I agree that my phone number and or email may be used by YCQ to contact you via electronic and other methods.

Signature(Required)

Registration Fee(Required)

Price: $0.00

Payment Type(Required)

This page is unsecured. Do not enter a real credit card number! Use this field only for testing purposes.

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Total

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