We offer the following example of a registration form to use as a base for your school.
Feel free to change, delete, or add to anything that does not meet your needs.

Tuition Reduction Incentive Program
C----- C-------- SCHOOL
School Year 199x-200x


Please SIGN and return ENTIRE form with your first order each school year!

1. To be filled in by all who participate in T.R.I.P.:

Your Name___________________________________________________________
                         (Last     First     MI)

Address ________________________________________________________

City _________________ State ____ Zip _________  Telephone (__)_________

Family Number at CCS ________________ (if your child is enrolled at CCS in K-8)


Friends of CCS (no children enrolled in CCS) may direct their earnings to: (please check one)

   [ ] Family of _________________________
   [ ] General Tuition Assistance Fund
   [ ] Mothers' Club Operating Fund
   [ ] CCS Foundation

Would you like to keep your donation confidential? [ ] Yes [ ] No

2. DISCLAIMER. Complete this part if your child is permitted to bring your certificates home. Your child will receive only the envelope of certificates ordered under your family number. Certificates will not be sent home with your child if you do not include this signed DISCLAIMER with your first order.

I AUTHORIZE MOTHERS CLUB TO RELEASE MY T.R.I.P. GIFT CERTIFICATES TO MY CHILD. I WILL NOT HOLD C----- C------- SCHOOL OR THE MOTHERS CLUB RESPONSIBLE FOR ANY LOST OR MISPLACED CERTIFICATES.

Child's name: ___________________   Grade: _____  Teacher: ___________

      _______________________________________     Date ___/___/___
                        Parent's Signature

3. FUTURE FAMILIES ONLY. Complete this part if first child is not yet enrolled at CCS in K-8.

Projected date of enrollment:__________________________________

Child's name: ______________________________

4. We have read, understand and will abide by the policies of the T.R.I.P. program.

________________________________________ Date ___/___/___
                        Signature


OFFICE USE ONLY    GENERAL # _______     FUTURE FAMILY #_______


Revised July 15, yyyy - tripform.trp

Courtsey of MANNAger Systems   South Holland, Illinois  USA


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