corpus christi academy...tuition rates program enrolled tuition non parishioner parishioner half day...
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CORPUS CHRISTI ACADEMY
Sacred Heart of Jesus Parish Saint Clare Parish
Please print clearly in black or blue ink.
Registration forms are to be submitted to Corpus Christi Academy Office.
Parent Name___________________________
Student Last Name____________________________
Pre-Kindergarten Registration Agreement 2020-2021 School Year
Registering as Parishioner: ( ) Sacred Heart of Jesus ( ) St. Clare ( ) Holy Rosary
OR ( ) Non-Parishioner Registering as: ( ) Catholic ( ) Non-Catholic
Registration is complete ONLY upon following:
(1) Tuition payments are current for 2019-2020 with Corpus Christi Academy.
(2) Payment of $100 per student must accompany this Agreement. Registration Fee is non-refundable.
(3) Corpus Christi Academy and Parish Business Office review for accuracy and completeness.
(4) Immunizations and Entrance Forms (required for all Pre-Kindergarten students)
(5) Birth Certificate, Baptismal Certificate (if applicable) (new students)
Father/Guardian Information Mother/Guardian Information
( ) Custodial ( ) Non-Custodial ( ) Custodial ( ) Non-Custodial
Name __________________________________ Name ___________________________________
Address ________________________________ Address__________________________________
_________________________________ __________________________________
E-mail _________________________________ E-Mail___________________________________
Phone __________________________________ Phone___________________________________
(Please mark preferred phone) (Please mark preferred phone)
Student Information
Name (First & Last) Date of Birth Grade 2020-21 N (New) or R (Return)
____________________________ ________________ ________ _________
____________________________ ________________ ________ _________
____________________________ ________________ ________ _________
____________________________ ________________ ________ _________
CORPUS CHRISTI ACADEMY
2020-2021 Pre-K Tuition and Fees
Pre-K Students Non-Parish Half Day Full Day
Non-Parishioner Tuition
2,600
4,250
Registration fee (per student)
100
100
Family Total $ 2,700 $ 4,350
Pre-K Students In Parish Half Day Full Day
Active Parishioner Tuition 2,500 4,050
Registration Fee (per student) 100 100
Family Total $ 2,600 $ 4,150
Active Participation and Parish Contributions
The full cost to educate each Pre-K student is approximately $4,764.65. The difference between full cost
tuition and each student’s tuition is covered by subsidies from Saint Clare and Sacred Heart of Jesus Parishes funded through:
*Offertory contributions by active parishioners
*Full participation in fundraising activities
Your committed and consistent support of your parish and Corpus Christi Academy enable the reduced Active
Parishioner rate and demonstrates your appreciation for the support being provided by other members of
your parish.
Corpus Christi Academy
2020-2021 Tuition Payment Agreement
Family Name:
Student/Grade:
_________________________________ ________ ________________________________ ________
_________________________________ ________ ________________________________ ________
Total Family Tuition (prior to application of financial assistance): $4,250.00 Full Day
$2,600.00 Half Day
Fees:
• $100.00 non-refundable registration fee per student
Total Family Tuition and Fees: $4,350.00 Full Day
$2,700.00 Half Day
I agree to pay Corpus Christi Academy the tuition and all fees for the attendance of my child(ren) as established by the school for the 2020-2021 school year. I elect to pay the tuition and fees as follows. Please mark
preferred payment method(s):
Preferred
Payment
Option
Payment Type Payment
Amount
Payment Guidelines and Due Date
One Full Payment by cash
or check
Make checks payable to Corpus Christi Academy.
Payment due July 20, 2020. ($100.00 discount if tuition
paid on or before July 5, 2020.)
Semi Annual Payment by
cash or check
Make check payable to Corpus Christi Academy.
Payment due July 5, 2020 and December 5, 2020.
St. Margaret & Gregory
Credit Union loan
Pre-approved, interest bearing loan. Eleven monthly
payments beginning July 20, 2020. Please contact the
Credit Union directly at 216-691-0242.
One payment and semi-annual payment may be completed by using FACTS.
One Full Payment
through FACTS No additional fee. Payment due July 20, 2020.
Semi Annual Payment
through FACTS
$10.00 additional fee. Payments will be made on July 5
or 20 and December 5 or 20.
Monthly payment plan set forth below must be completed
by using FACTS as applicable.
11 Monthly Payments
through FACTS*
$45.00 additional fee. Payments will be made on
the 5th or 20th of the month beginning July 2020 and
ending May 2021. Balance must be brought to zero
with the final payment due on the Friday before
Memorial Day
Total Payments:
Total Family Tuition & Fees Due as listed above:
__________________________________
*If you choose a payment plan to use FACTS, you must enroll in FACTS Tuition Management at the following web
address: https://online.factsmgt.com/signin/4KS7J. Please note that credit card fees may apply if you choose to pay by
credit card.
ADDITIONAL TERMS AND CONDITIONS
1. I agree that all payments owed under this Agreement will be paid by the due date corresponding to the
payment method(s) selected above. I understand and agree that, regardless of what payment option is
selected, I am personally responsible for the payments and for ensuring that the tuition and fees are paid
in full. Should I be late in making any payment, I understand that the following process will be followed:
a. I, and the other parents/guardians (if they are not me), will be notified of any payment not
received. Notification will be via email from FACTS or Business Office.
b. I will be given 30 calendar days to bring the account to current status or meet with school
administration to have an adjusted payment agreement approved (not a guarantee and must be in
writing and signed by the parish pastor or school president).
c. A $25.00 late fee will be assessed.
d. If, within 30 calendar days, the account is not brought to current status, and an adjusted payment
agreement is not agreed upon and approved by school administration, the student enrollment will
cease at the end of the current quarter, and the school may immediately take any action available
and consistent with applicable law in order to collect unpaid tuition owed by me/us including but
not limited to limiting access to field trips and extra-curricular activities, withholding academic
transcripts, referral to a collection agency, and/or the institution of a civil lawsuit to recover the
unpaid balance.
2. Any family with an unpaid Tuition and/or Fees balance for the current School Year will not be allowed to
register for the following School Year and School records, diplomas or transcripts will not be released
until the current year’s Tuition and fees are paid, unless special arrangements have been made in
writing and signed by Parish pastor or School president.
3. Prepaid Tuition will only be refunded in full if written notice of cancellation is received by the School
before the first day that classes for the School year are scheduled to start. The Registration Fee is non-
refundable.
4. Once the School year begins, Tuition refunds are made on a quarterly basis. Should a Student attend
School during any portion of a quarter (one day or more), the full tuition amount for that quarter is
owed and no portion of that quarter’s tuition will be refunded.
5. The Student(s) and Student's parents/guardians agree that they and their child(ren)/ward(s) will abide
by the policies and guidelines as stated in the School handbook.
6. Returned checks: If two checks are returned for insufficient funds, the school will no longer accept
personal checks and you will be required to pay in cash, with a certified check from a local bank, or
through an approved electronic payment provider (such as FACTS) at the school’s discretion.
(continued on next page)
(continued from previous page)
7. I understand that the School will not reserve a place for my child(ren) for the upcoming school year until
after I have returned a completed and signed Tuition Agreement, plus the registration fee, and, if
applicable, an agreement has been created in FACTS for selected plans. I further understand that my
child’s/children’s eligibility for enrollment is conditioned upon (1) his/her/ successful completion of the
current School Year; (2) full payment of all Tuition and fees owed for the current and/or prior School
Years; and (3) acceptance by the school. I understand that the School reserves the right to deny
admission or enrollment for any lawful reason.
By signing below, I agree that I have read and understand all of the terms and conditions contained in this
agreement, and I agree to be personally bound by those terms and conditions.
________________________________________ __________________________________________
Parent/Guardian 1 Date Parent/Guardian 2 Date
_________________________________________ __________________________________________
Print Name Print Name
_________________________________________ __________________________________________
Telephone (Please mark preferred phone.) Telephone (Please mark preferred phone.)
_________________________________________ __________________________________________
Mailing Address Mailing Address (if different from Parent/Guardian 1)
_________________________________________ __________________________________________
City/State/Zip City/State/Zip
ALL FAMILIES MUST COMPLETE THIS FORM. REGISTRATION FOR THE 2020-2021 SCHOOL YEAR WILL NOT BE
ACCEPTED WITHOUT THIS FORM AND THE $100.00 NON-REFUNDABLE REGISTRATION FEE.
Corpus Christi Academy Catholic School
Tuition Rates and Scholarship Application for 2020/2021 School Year
Every Pre-K student at Corpus Christi Academy Catholic School may apply for scholarships. Working
in partnership with parents, who are the primary educators of their children, we want to ensure that the
young people in our school community have an opportunity to receive an affordable Catholic education.
Please apply for scholarships for the school using this worksheet, and additional forms as needed. Once
you have completed the form, please return it to Corpus Christi Academy, at the school office, or the
business office for processing. Families will be notified of scholarship awards as soon as possible.
Family Name: Date:
_____________________________________________ ___________________
Please list student(s) and grade(s): if there are more than six students, please list additional students on
the back
______________________________ ________ ______________________________ ________ ______________________________ ________ ______________________________ ________ ______________________________ ________ ______________________________ ________
TUITION RATE Pre-K
Please note that it costs Corpus Christi Academy Catholic School approximately $6,500.00 to educate per
pupil, at current enrollment levels. The Parishes covers the substantial financial difference between per
pupil cost and the actual tuition through its weekly offertory collection and otherwise through the
generosity of those associated with the Parishes.
Tuition Rates
Program
Enrolled
Tuition
Non Parishioner Parishioner
Half Day $2,700.00 $2,600.00
Full Day $4,350.00 $4,150.00
SCHOLARSHIPS
Corpus Christi Academy Catholic School offers scholarship opportunities that may be available to help
offset the cost of educating your child. Please indicate which scholarships option you are applying for by
placing a checkmark in front of the appropriate option(s):
_______ 1. Parish scholarship: $100.00 per student for Half Day Enrollees
This scholarship is available to those families who are registered at Sacred Heart of
Jesus, Church of St. Clare or Holy Rosary Parishes, and who regularly participate
in the life of the Parish, including regular attendance at Mass as determined in the
Parish’s discretion and as evidenced by the use of offertory cards or envelopes,
regardless of whether a donation is made.
_______ 2. Parish scholarship: $200.00 per student for Full Day Enrollees
This scholarship is available to those families who are registered at Sacred Heart of
Jesus, Church of St. Clare or Holy Rosary Parishes, and who regularly participate
in the life of the Parish, including regular attendance at Mass as determined in the
Parish’s discretion and as evidenced by the use of offertory cards or envelopes,
regardless of whether a donation is made.
.
Please note final scholarship is determined by Parish Offices. Prior to your student being enrolled, you
will be required to sign a tuition agreement. In addition, prior to your student being enrolled, all
required paperwork and forms must be submitted to the Corpus Christi Academy school office and
payment of the non-refundable registration fee must be received and tuition agreement commitments must
be implemented, such as FACTS registration, etc.
________________________________________________ _____________
Parent/Guardian Signature Date
________________________________________________ Print Name
Family Name:__________________________________________________________
Number of Students________________________ Grade Level (s)__________________________
Tuition Rate_______________________________ ()Qualifies for Parishioner Rate
BALANCE OF THIS PAGE - OFFICE USE ONLY
(a)______________ Review Registration Agreement for completeness
(b)______________ Registration Fee ($100/student) Check No.________ Cash_________
(c)______________ Parishioner status checked
(d)______________ Current on tuition payments checked
(e)______________ Tuition Payment Preference Form completed
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Received by____________________________________ Date Received__________________
Registration Approved by ___________________________ Date Approved___________________
School Registration Checklist: Pre-K
Child’s Name: __________________________________________
Grade for 2020-2021: Pre-K
Items REQUIRED at the time of Registration:
_______ School Registration Packet with signed Tuition Payment Preference Form
_______ Registration Fee - $100 per student Cash _______ Check #_______
_______ Emergency Authorization Medical and Contact Form
_______ Legal Custody Agreement Form
_______ Permanent Record Card
_______ Birth Certificate (copy)
_______ Baptismal Certificate (copy) – If applicable
_______ Preschool Medical Record & Physical Form with Immunization Records
Corpus Christi Academy 5655 MAYFIELD ROAD
LYNDHURST, OHIO 44124 (440) 449-4244
EMERGENCY MEDICAL AUTHORIZATION
2020-2021 SCHOOL YEAR
Family Name:___________________ First Name:__________________ Middle Name:______________
Sex: (circle) M F Grade Level:_____________ Date of Birth:________________
Business Phones: (Father):( )____________________ (Mother): ( )________________________
Cell Phones: (Father):( )_______________________ (Mother): ( )________________________
Address:___________________________ City:_______________ Home Phone: ( )_______________
Mother or Guardian:____________________ Occupation:___________________ With Family:____________
Father or Guardian:_____________________ Occupation:___________________ With Family:___________
IF I CANNOT BE CONTACTED and it is advisable to send my child home due to minor illness, injury
or emergency, my child can be released in the custody of: Name:________________________ Address:___________________________ Phone:____________________
Name:________________________ Address:___________________________ Phone:____________________
Name:________________________ Address:___________________________ Phone:____________________
*Must show proof of identification to be able to release said student.
Date:_________ Signature of Parent or Guardian:_________________________________
FACTS CONCERNING THE CHILD’S MEDICAL HISTORY INCLUDING ALLERGIES, MEDICATIONS BEING TAKEN, AND ANY PHYSICAL IMPAIRMENTS TO WHICH A
PHYSICIAN SHOULD BE ALERTED. PLEASE INCLUDE GLASSES/CONTACTS,
ORTHODONTIC APPLIANCES OR MEDICATIONS TAKEN AT HOME. _______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________
Date:_________ Signature of Parent:___________________________________________
Transportation: (please check one) Bus_________ Walk________ Parent Pick-Up_________ If your child does not go directly home after school, please list where the child goes, on what days, with
phone numbers. Name_____________________________________________Phone Number_______________________ M T W TH F
*CONTINUE TO BACK OF THIS PAGE TO COMPLETE FORM*
Please provide your child’s medical-care provider information below: Doctor: Name:_________________________________________
Address:_______________________________________
Phone No.: ( )_______________________________
Dentist: Name:_________________________________________
Address:_______________________________________
Phone No.: ( )______________________________
PRIVACY ACT: It is understood that no student information will be given out without parental consent. However, we wish to inform you that your name and home phone number will be given
to selected adults who will keep the information confidential and will use it only to inform you of emergency situations. This procedure will replace our old method of informing parents of an
emergency school closing. If you have any problem with this policy, please call me in the school office at
(440) 449-4242. I have read the above statement regarding the Privacy of Student Information.
Date:_____________ Signature:_________________________________
PART I OR II MUST BE COMPLETED
PART I (TO GRANT CONSENT) In the event reasonable attempts to contact me at: ( )__________________ or _______________________ (phone) (other parent) at ( )_____________________ have been unsuccessful, I hereby give my consent for:(1) the administration of any treatment deemed necessary by Dr._____________________, or Dr.______________________ or in the (dentist) (physician) event the designated preferred practitioner is not available, by another licensed physician or dentist; and (2) the transfer of the child to:____________________________________ hospital or any hospital reasonably accessible. This authorization does not cover major surgery unless the medical opinions of two other licensed physicians or dentist, concurring in the necessity for such surgery, are obtained before surgery is performed.
Date:_______ Signature of Parent or Guardian:___________________________________
PART II (REFUSAL TO CONSENT)
DO NOT COMPLETE PART II IF YOU COMPLETED PART I
I do NOT give my consent for emergency medical treatment of my child. In the event of illness or injury requiring emergency treatment, I wish the school authorities to take no action
or:to:_____________________________________________________________________________________ _________________________________________________________________________________________
Date:_________ Signature of Parent or Guardian:_________________________________
CORPUS CHRISTI ACADEMY
2020-2021
INFORMATION REGARDING LEGAL CUSTODY
Date:_______________________
Student Name(s):________________________________________________ Grade:________
_________________________________________________Grade:________
_________________________________________________Grade:________
_________________________________________________Grade:________
Address of student residence:_________________________________________________
_________________________________________________
Student lives with: _____ both parents
_____ mother as residential parent
_____ father as residential parent
_____ grandparent(s) (with legal custody)
_____ other - Please explain:________________________________
Residential parent/guardian:
Name: _____________________________________________________________
Address:_____________________________________________________________
City, Zip: _____________________________________________________________
Phone: _____________________________________________________________
Is there a court order (or pending order) affecting the custody and/or residency of the student(s)?
_____YES* _____ NO
*If yes, please attach a certified copy of the entire court order including the case number and
those sections referring to visitation rights and contact with the school. Also include the page
bearing the judge’s signature and court seal. This copy should include any and all modifications
made as of the date of registration of the student(s) in this school. It is also the responsibility of
the parents to inform the principal of any subsequent modifications during the student(s) tenure
at the school.
Non-residential parent:
Name: ______________________________________________________________
Address: ______________________________________________________________
City, Zip: ______________________________________________________________
Phone: ______________________________________________________________
Does the non-residential parent have visitation rights?_____YES _____NO
Is there a court decision that states that the non-residential parent should NOT receive school
information or attend school activities?
_____YES _____NO
Is the non-residential parent responsible for paying tuition? _____YES _____NO
PreSchool Entrance Medical Record & Physical Form Child’s Name Date of birth
___This above named child has been examined, the immunization status recorded, and the child is in suitable condition for participation in group care. ___This above named child has been immunized in accordance with the requirements of section 5104.014 of the Ohio Revised Code (please note any exceptions below Signature of examining Physician/Physician’s Assistant/Advanced Practice Registered Nurse/Certified Nurse Practitioner
Date of Examination
Name of Physician/Physician’s Assistant/Advanced Practice Registered Nurse/Certified Nurse Practitioner
Telephone Number
Street Address City, State and Zip Code
ATTACH A COPY OF THE CHILD’S IMMUNIZATION RECORD WITH DATES OF DOSES OF
ALL IMMUNIZATIONS
Exceptions to immunization requirements pursuant to 5104.014 ORC (please include names of requirements diseases against which the child has not been immunized and whether it is because the immunization is medically contraindicated, not medically appropriate for the child’s age, or declined by the parent). ____I have declined to have my child immunized against one or more of the diseases required by 5104.014 of the Ohio Revised Code. Please note above and sign Signature of Parent
Date of Signature
OPTIONAL Recommended Assessments/Screenings Vision ___Yes ___No Lead ___Yes ___No Hearing ___Yes ___No Hemoglobin ___Yes ___No Dental ___Yes ___No Other Measurements Notes Height Weight BMI