Please click this this link to download an editable copy of the Application Form.

STARBRIGHT PRESCHOOL

3900 Valley View Road       Austin, Texas 78704       (512) 441-5253

Wait List Application and Contract of Deposit Form

I would like to place my child on the wait list at Starbright.

Child’s Name ____________________________________________________________ Date of Birth ___________________

Parent/Guardian ___________________________________________________ Phone (home) _________________________

Phone (work) ________________________ Cell _______________________ Email __________________________

Address ___________________________________________________________________ Zip _________________

Parent/Guardian ___________________________________________________ Phone (home) _________________________

Phone (work) ________________________ Cell _______________________ Email ___________________________

Address ___________________________________________________________________ Zip _________________

Enrollment Starting Date Preferred ________________________

Preferred Attendance: (M W F or T Th or M – F or Any days that are available /7:00 – 2:30 or 7:00 – 6:00 or 2:30 – 6:00)

1st M W F _____ T Th_____ M – F _____ Any days that are available ______ Hours _______________

2nd M W F _____ T Th_____ M – F _____ Any days that are available ______ Hours ______________

3rd M W F _____ T Th_____ M – F _____ Any days that are available ______ Hours _______________

More information: ________________________________________________________________________________________

(initial each of the following)
• _____ I understand that Starbright is a small school and that only a relatively small number of spaces becomes available at Starbright each year. I understand that the wait list is therefore unpredictable. The wait could be one to two years.

• _____ I am enclosing the $50.00 non-refundable wait list fee to secure a place on the Starbright Wait List.

• _____ I understand that I will not be placed in line on the Wait List without both this form and the deposit.

• _____ Even though I have chosen a preferred start date for my child I understand that openings are offered as they become available. I understand that there is no guarantee that an opening will be available on that preferred date and that I could be offered a start date that is different from my preferred date Most openings occur during the summer or early fall. The school cannot hold an unpaid space.

• _____ I understand that I could be offered an attendance option that is different from my first or second choice. And I understand that if I have only one preferred choice that it might not become available.

• _____ I understand that applying for a part time opening does not guarantee my first choice of days and hours.

• _____ I understand that Starbright will only be able to hold an offered space for 48 hours. If I do not confirm that I am accepting the offered space within 48 hours I will lose that offered space.

• _____ I understand that if one of my choices for attendance is offered and refused, that I will be moved to the bottom of the list if I wish to continue on the wait list. It is my responsibility at that point to renew my intentions by phone at regular intervals.

• _____ I understand that I need to call Starbright immediately with any changes to any of the above in order to keep this application active.

• _____ I understand that I need to check in with Starbright every six months so that Starbright knows I am still interested.

• _____ I understand and agree to Starbright’s Fees and Tuition.

Any further information that we should know about your family and / or child: _______________________

_______________________________________________________________________________________

The parent(s) must sign this form.

Parent Signature _______________________________________

Date _____________________

Parent Signature _______________________________________

Date _____________________

Office Use: Check # ______________ Received _______________ Amount ___________________