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Holy Family Catholic High School
5
Student’s Last Name
Student’s First Name
2 0 1 5 - 20 1 6 Sch ool Yea r
T u i tion C on tract
Grade Entering (in 2015-2016)
I . s tu d e n t i n f o r m a t i o n
Full Legal Name __________________________________________________________________________________________
Last
Grade in 2015-2016 ________________________________
First
Middle
□ Male □ Female
Address __________________________________________________________________________________________________
_Student resides with:
Street
City
State
Zip
□ Parents □ Mother □ Father □ Mother and Stepfather □ Father and Stepmother
□ Guardian: ______________________
Relationship
I I . p a r e n t / g u a r d i a n in f orma tion *
*Both parents’ signatures are required on the contract. Both parents are jointly and severally responsible for full tuition payment.
Father/Guardian Name _______________________________________________Home Phone ( _____ )_________________
Last
First
Home Address ____________________________________________________________________________________________
(If different from student’s) Street
Marital Status: □ Married □ Single □ Divorced
City
□ Separated
State
Zip
If remarried, spouse name___________________
Cell Phone ( _____ )_______________________________Work Phone ( _____ )_____________________________________
Preferred E-mail__________________________________________________________________________________________
Mother/Guardian Name ________________________________________________Home Phone ( _____ )________________
Last
First
Home Address ____________________________________________________________________________________________
(If different from student’s) Marital Status: □ Married
Street
City
□ Single □ Divorced □ Separated
State
Zip
If remarried, spouse name___________________
Cell Phone ( _____ )_______________________________Work Phone ( _____ )_____________________________________
Preferred E-mail__________________________________________________________________________________________
Are all parties authorized to receive school information?
□ YES □ NO
I I I . a l t e r n a t i v e b i l l i ng in f orma tion *
*All parties’ signatures are required on the contract. All parties are jointly and severally responsible for full tuition payment.
□ Split tuition and fees, and bill each party separately.
□ Additional Party Billing:
Billing Name ______________________________________________________________________________________________
Last
First
Relation to Student _____________________________ Marital Status: □ Married
Middle
□ Single □ Divorced □ Separated
Home Phone ( _____ )_____________________________________ Cell Phone ( _____ )______________________________
Billing Address ________________________________________________________________________________________
Street
City
State
Zip
Preferred E-mail ________________________________________________________________________________________
To provide special instructions, contact the Business Office at 952-443-4659 ext.3161
IV . 2015- 2 0 1 6 s c h o o l y e a r tu ition : $ 1 3 ,990
V . t ui t i o n p o l i c y
This tuition contract represents each signer’s commitment to pay the entire 2015-2016 tuition amount, or the adjusted amount due
after financial aid, even if the above-named student withdraws for any reason, leaves the school during the year for any reason, or
is expelled after July 1, 2015 for any reason as outlined in the Student Handbook.
• If written notice of withdrawal is received by Holy Family prior to July 1, 2015, the entire portion of the tuition due will
be forgiven, and if paid, will be refunded.
• If written notice of withdrawal is received by Holy Family from July 1, 2015 through July 31, 2015, two-thirds of the
tuition will be forgiven, and if paid, will be refunded.
• If written notice of withdrawal is received by Holy Family from August 1, 2015 and prior to the first day of school,
one‑half of the tuition will be forgiven, and if paid, will be refunded.
• After the first day of school, no portion of tuition paid or tuition due will be forgiven, refunded, or cancelled in the event
of absence, withdrawal, or dismissal from school.
V I . d e l i nq u e n t t u i t i o n p o licy
The following policy applies to delinquent tuition. Only the President/Principal and VP of Finance may approve, in their sole
discretion, exception to this policy. If tuition cannot be paid on time, you must communicate with the President/Principal or
VP of Finance in writing to prevent enforcement of delinquent tuition procedures. Any such exceptions will be provided in writing
by the President/Principal or VP of Finance.
• Students with delinquent tuition may not be permitted to begin a semester.
• Students with delinquent tuition payments may not be permitted to participate in extracurricular activities.
• Students with delinquent tuition at graduation will not receive their diplomas until outstanding balances are paid in full.
V I I . fe e s / t u i t i o n
• Accounts more than 30 days past due may be assessed a 0.66% finance charge per month.
• Checks and Automated Clearing House (ACH) payments that do not clear the bank may be charged a $35 NSF fee.
• Students may be charged for other miscellaneous fees (lost books, parking, etc.)
• Parties signing this tuition contract are responsible for all costs incurred for the collection of past due accounts.
• Accounts requiring collection action will be liable for attorney fees and costs.
• Parties signing this tuition contract agree to jurisdiction and venue in Carver County District Court.
V I I I . ac t iv i t y f e e
Funding for the numerous opportunities and activities provided outside the classroom is not covered by tuition. To fund these
expenses, there is a $450 activity fee per student. Payment is due August 1, 2015 and will be billed on your August tuition
statement. For families using the monthly ACH electronic payment method, the activity fee will be processed via a separate
ACH transaction on August 4, 2015.
Student involvement in activities and athletics is strongly encouraged. Payment of the activity fee does not guarantee
selection in the various activities and participation will be based on the results of the tryouts and team selection processes.
The activity fee funds school plays, Math League, Knowledge Bowl, Mock Trial, vocal and instrumental music groups, school
clubs, Lasallian Youth, all-class retreats, and sports. In addition, the activity fee subsidizes the transportation expenses for
these activities.
Additional fees will be charged per participating student for the following: hockey, co-op sports, dance costumes, and overnight
trips. These additional fees will be due prior to the respective activity/sport.
IX. s e ni o r g r a d u a t i o n f e e
There is a $150 graduation fee for seniors. This fee will be included on senior parents’ tuition statements and billed under the same
payment option as tuition. Accordingly, if payment option 10 is selected, $15 will be added to monthly ACH transactions.
X. pay m e n t o p t i o n s
Families may select one of the four payment options listed below. If you have any questions regarding this contract or the payment
options, please call the business office at 952.443.4659 ext 3161. If a method of payment is not selected, option 10 will be
used.
□ Option 1: One installment of $13,990. Payment is due August 1, 2015 or upon receipt of bill, if registered after August 1, 2015.
□ Option 2: Two installments of $6,995. Payment is due August 1, 2015 and January 1, 2016.
□ Option 3: Three installments: Payment of $4,664 is due August 1, 2015; payment of $4,663 is due November 1, 2015;
final payment of $4,663 is due March 1, 2016.
□ Option 10: Monthly installments of $1,399. All payments will be withdrawn electronically from accounts on the first of each
month between August of 2015 and May of 2016. Families using monthly installments must complete the ACH
Enrollment Form and return it with this contract. Families currently enrolled in the ACH payment plan do not need
to fill out a new enrollment form. All families receiving tuition assistance are required to select this option.
XI . d o nati o n o f s t a t e b u s reimb u rsemen t ( option a l)
Families who do not reside in the Eastern Carver County School District #112 boundaries may be eligible for a state
transportation reimbursement. Some districts transmit the reimbursement to Holy Family and have Holy Family issue the
reimbursement checks to the families. If you wish to donate your reimbursement to Holy Family, you may select this option.
Holy Family retains your reimbursement and provides you with a receipt for your tax deductible donation.
□
I would like to donate my transportation aid to Holy Family Catholic High School.
XI I . s i gna t u r e *
*Both parents/parties must sign or contract will be returned as incomplete.
I have carefully read, fully understand, and will abide by all the terms of this tuition contract. All necessary forms, including this
completed and executed contract, must be submitted to complete the enrollment process.
• One signature is required for single parents with sole financial responsibilities.
• Two signatures are required for all other contracts.
• Each signer is jointly and severally responsible for all amounts due under this tuition contract.
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Father/Guardian Signature
Date
Mother/Guardian Signature
Date
Additional Party Signature XI I I . r e t u r n t o :
Holy Family Catholic High School
8101 Kochia Lane
Victoria, MN 55386
www.hfchs.org • 952.443.4659
Date
for offi c e us e onl y
Name (Last, First):
Tuition:
Payment Option: 1 2 3 10
FIRE Award:
ID:
Tuition Assistance:
Donate Bus:
Net:
Yes
No