PK Registration 2019-20Offline
Progress: Enter data in the Form ->Review form->Submit

* Click 'Next' to go to the next step.
    1       Review    
Mt. St. Mary Academy

Registration 2019-20

Registration Fees:
$300 per student if paid by June 5, 2020
$350 per student if paid by July 15, 2020
$400 per student if paid by August 15, 2020
Registration fees are non-refundable. 
Registration Enrollment Information
Family Name *
Student's Name *
First Name * Middle Name Last Name *
Primary Home Address *
Address1 City State Zip
Parent/Guardian 1 Name *
First Name * Last Name *
Email Address *
Address1 City State Zip
Home Phone
Cell Phone *
Employer *
Parent/Guardian 2 Name
First Name Last Name
Address (if different)
Address1 City State Zip
Home Phone
Cell Phone
Tuition Contract Agreement Terms  
Please read the following Tuition Contract Agreement Terms. Initial each area and sign below as an indication of your acceptance and obligation to the school community of Mt. St. Mary Academy.
1 *
I/We hereby enroll our student(s) at Mt. St. Mary Academy for the academic year of 2020-2021.
2 *
I/We agree to participate in a faith community, as Disciples of Christ, who give of their stewardship, participate in worship, give of their time, talent, and treasure.
3 *
I/We will abide by School and Diocesan regulations and policies set forth in the Parent/Student Guidelines.
4 *
I/We acknowledge and agree to pay the Tuition Rates according to the Tuition Rates set forth for the 2020-2021 School Year and acknowledge that the payment plan will be utilized through FACTS Payment Processing.
5 *
I/We agree to pay Registration, Classroom Supply, Parent Club, Gala Auction Fees (All fees are non-refundable).

The Tuition Contract Agreement is a binding contract creating a legal and financial obligation to pay your tuition in a timely fashion. If your tuition payments are not made as you have agreed to do, Late fees will be assessed, there is a risk that report cards, transcripts, and participation in graduation activities may be withheld. Tuition must be paid in full by the end of the school year to qualify for enrollment the following year. If a student withdraws during the school year, the school will not provide a transcript until the account is paid in full, which may include future charges to be billed or any other charges that have not been generated to date. In most circumstances, both of the student’s parents, will be the responsible parties and signatories of this contact. If there is one signatory, that signatory is assuming sole and complete financial responsibility for the student. Delinquent tuition payments, or unwillingness to follow a payment plan, may result in the removal of your student(s) from Mt. St. Mary Academy.

My/Our signature indicates that I/we have read and understand these terms. Enrollment is not complete until this Tuition Contract Agreement is completed and signed by you and approved by Mt. St. Mary Academy. All Tuition Contract Agreements are Confidential. The selection of Tuition Contracts Standard or Active Parishioner Tuition is based upon final approval of the Mt. St. Mary Academy Principal.

Parent/Guardian Signature *
Name * Date (MM/DD/YYYY) *
Contract Agreement  
Tuition Contract Agreement at the time of Registration
Please review, select and sign below the Volunteer Agreement Options.
Fundraising/PIP Hours

Room Parent Fee: *
I/We agree to pay a $35 Room Parent Fee for Gala, Hoe Down Projects, and Teacher Appreciation Gift.
Class Room Supply Fee: *
I/We agree to pay a $50 classroom fee to purchase supplies used throughout the school year. 
Gala/Annual Auction: *
I/We agree to contribute/procure a $50.00 product or service for the Gala.
Parent/Guardian Signature *
Name * Date (MM/DD/YYYY) *
Tuition Payment Options  
Tuition Payment Options:

Mt. St. Mary Academy now uses FACTS PAYMENT PROCESSING for the collection of tuition. Families may opt for monthly, quarterly or semi-annual payments in the form of automatic debit, credit card, or check.
Mt. St. Mary Academy Tuition is payable from July 2020 to May 2021. Please review and understand appropriate Tuition Payment Options that are available to you and for your family to follow for the 2020-2021 school year. Please review and select below, so you understand and agree to the payment options.
Please select one *

Desired enrollment *

Please specify the days attending *

Please select one *

Parent/Guardian Signature *
Name * Date (MM/DD/YYYY) *
Please Direct all Registration Inquiries to the School Office
Mt. St. Mary Academy 
400 South Church Grass Valley, CA 95945 • (530) 273-4694• fax (530) 273-1724 • •
    1       Review