Apply to ECP

Thank you for your interest in the Harmony School Early Childhood Program!

* (denotes required field, use N/A if not applicable)

E-Mail Address:*

Student's name:*

Date of Birth:*

Place of Birth:*

Gender:*

Male
Female

Parent #1 Name:*

Home Address:*

City*

State/Province:*

Zip/Postal Code:*

Home Phone:*

Email Address:*

Workplace:*

Occupation:*

Work Phone:*

Cell Phone:*

Hobbies/Interests:*

Parent #2 Name:*

Home Address (if different from above):*

City:*

State/Province:*

Zip/Postal Code:*

Email Address:*

Workplace*

Occupation*

Workphone:*

Cellphone:*

Hobbies/Interests:*

Names and ages of student's siblings:*

Do you know anyone associated with Harmony School?*

Yes
No

If so, who do you know?

Harmony School has a Parental Involvement Program (PIP). Families are required to complete 45 hours of volunteer work for the School. What skills could the parents share with the community?*

Other Comments:

Do you anticipate being in the Bloomington area during your child's elementary years?*

If so, are you interested in your child attending Harmony Elementary School?

Harmony Early Childhood Program fees are $525/month for full-time and $325/month for half-time (there are a very limited number of part-time slots available). If 8% of your family's gross monthly income is more than $525, you would pay that amount, up to a maximum of $675/month. Based on this scale what are your expected monthly ECP fees?*

Current School:*

How did you hear about Harmony?

*Please email officemanager@harmonyschool.org or call (812)334-8349 to confirm that we have received your application.