Harmony School Online Application
Early Childhood Program
Ages 3, 4, 5

Please fill out the following form and then click the "submit" button at the bottom of the page. In our efforts to be in touch with you, we may ask for more information. Please give us the most reliable contact information you possibly can. Thank you very much for your interest in Harmony School.

This application will be added to our wait list. Generally, interviews take place in late spring and early summer. If there is an opening in the applicant’s grade, you will be called for an interview.

All fields require an entry to submit the form. If a field does not apply or you do not have the information, please enter, "n/a" or some other character to let us know that you have reviewed that question.

Please enter your email address (valid email required):
Student's name:
Date of Birth:
Place of Birth:
Gender	Male Female
Parent #1
Home Address
City
State
Zip Code
Home Phone
Email Address
Workplace
Occupation
Work Phone
Cell Phone
Hobbies/Interests
Parent #2
Home Address
City
State
Zip Code
Home Phone
Email Address
Workplace
Occupation
Work Phone
Cell Phone
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?
What special interests or abilities does the student have that the student could share with the community?
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 $450/month for full-time and $275/month for half-time (there are a very limited number of part-time slots available). If 8% of your families monthly income is more than $450, you would pay that amount, up to a maximum of $600/month. Based on this scale what are your expected monthly ECP fees?
Are you applying for half-time or full-time in the ECP?

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Harmony Education Center
909 East 2nd Street, Bloomington, IN 47401
ph: 812/334.8349   fax: 812/333.3435
Comments? webmaster@harmonyschool.org
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