Haddonfield Friends School - Before and After - Extended Day Program Enrollment Form

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curriculum > before/after-school care > extended day enrollment form

Mailing Address:
47 N. Haddon Avenue
Haddonfield, NJ 08033-2476

Phone: (856) 429-6786
Fax: (856) 429-6376

If you are enrolling more than one child, please submit a separate form for each child.

Student Information

Name:

Grade Level:

Billing Information

Person responsible for making payments

Mr.

Ms.

Mrs.

Dr.

Name:

Address:

City:

State:

Zip:

Phone Number:

(xxx-xxx-xxxx)

Email:

Payment Schedule:

Single Payment

Three Payments

Monthly Payments

Regular Program Only

Per Diem Program Only

Regular and Per Diem Program

Worksheet:

Full Year Expenses (See Fee Schedule)

If enrolling only in the Per Diem Program, enter "PD" instead of dollars on the lines below.

Before School Session:	$
Days:	Monday Tuesday Wednesday Thursday Friday

After School Session:	$
Days:	Monday Tuesday Wednesday Thursday Friday
Pick-up Time:	5:00 pm 6:00pm

Total Expenses:	$
Financial Aid:	(-) $
Plan Amount:	$

Payment Needed to Enroll

	$45.00: Enrollment Fee Regular or Per Diem Program
	$60.00: Enrollment Fee Regular and Per Diem Programs

By clicking this box, I am indicating my agreement to use the HFS Extended Day Program for this academic year and to fulfill my financial obligation for the full fee.


or Pay Online

1. Payment Information
Credit Card Type
Cardholder Name
Credit Card Number	please do not use hyphens or spaces
Credit Card Expiration (mm/yy)	/

It is understood that the information contained in this registration, and that which is requested by either the school or the applicant family, is confidential and shall not be disclosed to anyone beyond those involved in the admissions process.

NOTE: No changes can be made once the application has been submitted. If you are unsure about any information, click Save to come back and make changes at a later date.

HFS: 47 N. Haddon Avenue; Haddonfield, NJ 08033-2476
Phone: (856) 429-6786; Fax: (856) 429-6376