Universal Leadership & STEAM Academy

REGISTRATION FORM FOR ALL ULSA PROGRAMS

Student’s Name: First *

Middle

Last *

Parent/Guardian Name *

Telephone Number *

Child's Address *

What School does your child attend? *

What time does school end for After school pickup? *

REGISTRATION FEES:

One Child:$50.00; 2nd Child: $45.00

WEEKLY TUITION RATES:

AFTER SCHOOL: One Child: $90.00; 2nd Child: $82.00

ALL CAMPS: One Child: $155.00 2nd Child: $145.00

NURSERY, PRESCHOOL EARLY STEPS, FIRST STEPS 4K:

Ages: 0-1year & 11 Mo.: $225.00

Ages: 2: $215.00

Ages: 2-4: $200.00

SCHOLARSHIPS: A Limited number of Scholarships for Registration, Tuition & Other Fees are available for Residents of Harbison Gardens. Scholarships are also available to members of Universal Outreach Church. REQUESTS FOR SCHOLARSHIPS SHOULD BE MADE UPON SIGNING.

***ABC VOUCHERS ACCEPTED. You may transfer ABC Vouchers from other centers. We will give you the date for this.

Parent/Guardian's Name Print *

Signature

Date *

Director’s Signature

Date

STUDENT REGISTRATION FORM [2.1]