Enrollment Form

Admissions Form

We are excited to have your child (ren) enrolling with Rising Stars Private School. Please fill out the information below. This information will be kept on file and in your child's school record.
Child's Name *

First Name Middle Initial Last Name
Child's Birth Date *

Month Day Year
Parent Name *

First Name Last Name
Parent/Guardian Name

First Name Last Name
Parent's Phone *

Area Code Phone Number
Parent/Guardian Number

Area Code Phone Number
Parent's E-mail Address *
Parent/Guardian E-mail Adress
example@example.com
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Name of other authorized individuals who can pick up, drop off & answer/ask questions about your Rising Star. In the event that someone else, other than persons you list on this form, will be picking up your child, a photo id will be required to be shown from the person, as well as prior authorization from the parent to allow the release of your child. This "authorization" can come in form of a verbal conversation, phone call, e-mail, note sent with child or phone text. Verbal communication from your child ALONE will NOT allow the release of your child!

Do you want to request transportation services for the student (S)? Do you need before school care/after school care services?

Is your Rising Start up to date on all immunizations or do you have an immunizations exempt form/statement? Please provide a copy of latest immunization records via e-mail (risingstars1120@gmail.com), with the subject line: Immunization, child's first and last name). You may also choose to mail it or send copy with child.
Tuition Fee

Payment is due the first business day of the month. Please make all checks & money orders out to Rising Stars Private School. A receipt will be written out for you, each time monies is paid. If you prefer to pay in cash, a receipt will be written out for you as well. We also accept electronic payments through paypal & Venmo (you will find the link on our website under "parent's portal" tab or you may pay directly from your paypal account by entering our e-mail address risingstars1120@gmail.com. If you prefer to pay by credit/debit card, we can generate an invoice for you that will allow you to pay in either method. Before & After school payments should be paid separately and paid at the end of every week care is provided (or at beginning of month).. While there are no late fees imposed on payments received after the first business day of the month, in the event that there will be delay in payment, please advise of this by sending an e-mail to risingstars1120@gmail.com.
Payment Method: *

Check/Cashier's Check Money Order Cash Paypal/Electronic Credit/debit card (invoice)

Admissions Form