The mission of Holy Spirit School is to serve God by ...

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W2796 County Road KK, Appleton, WI 54915 • 920-733-2651 • (Fax) 920-733-5440 Website: www.holyspiritknights.org • Email: [email protected] The mission of Holy Spirit School is to serve God by providing a challenging academic education within the Catholic Tradition. Welcome Holy Spirit Catholic School Families, Registration time is here! It’s hard to believe we are half way through the school year already. On behalf of the Education Committee and Fr. Carl Schmitt, I would like to thank you for entrusting our Holy Spirit School Faculty and Staff with assisting you and your child on your journey of Faith. Your continued support of Holy Spirit Catholic School’s mission, that of serving God by providing a challenging academic education within the Catholic Tradition, brings alive the traditions of our faith established so many years ago. How wonderful for students, parents, and faculty to be able to live, learn, love, and grow in their faith and relationship with Jesus Christ. Our Education Committee works to achieve our school’s mission by empowering students with the ability to make positive lifelong choices and become disciples of God. We continue to emphasize learning opportunities for all students based on our core values of Knowledge, Worship, Respect, Service, and Community. In order to maintain the level of excellence our school demonstrates academically and spiritually, we are challenged to find a financial balance between income, expenses, and future growth. In 2020-21, the cost of educating a child will be $8,000. Funding for this comes from the three main income sources: tuition, parish investment, and 3 rd source revenues (e.g., fundraising, grants, Mardi Gras, donations). We are blessed to have a Parish community which supports Holy Spirit Catholic School through their prayers, gifts, and parish investment. We also recognize school families and the many sacrifices they encounter by giving their child a faith- filled education at Holy Spirit Catholic School. We worked to design the 2020-21 school budget to address current and future financial needs of the school while preparing for future growth. Our goal is to continue to make Holy Spirit a viable educational choice for families where students can grow in their faith. Please check out our new on-line registration procedures at www.holyspiritknights.org. The Education Committee has set a goal for the 2019-20 school year: to increase K-8 th grade enrollment from 168 students in 2019-20 to 185 students for the 2020-21, while retaining 90% of 2019-20 families. Please help us reach our goal by registering your child. We look forward to another year of working in harmony with Holy Spirit Catholic School families, parishioners, and friends to enhance our school’s vision and mission. The difference truly is inside! Blessings, Mike Zuleger Fr. Carl Schmitt The Education Committee

Transcript of The mission of Holy Spirit School is to serve God by ...

Page 1: The mission of Holy Spirit School is to serve God by ...

W2796 County Road KK, Appleton, WI 54915 • 920-733-2651 • (Fax) 920-733-5440

Website: www.holyspiritknights.org • Email: [email protected]

The mission of Holy Spirit School is to serve God by providing a challenging academic education within the

Catholic Tradition.

Welcome Holy Spirit Catholic School Families,

Registration time is here! It’s hard to believe we are half way through the school year already.

On behalf of the Education Committee and Fr. Carl Schmitt, I would like to thank you for

entrusting our Holy Spirit School Faculty and Staff with assisting you and your child on your

journey of Faith. Your continued support of Holy Spirit Catholic School’s mission, that of serving

God by providing a challenging academic education within the Catholic Tradition, brings alive the

traditions of our faith established so many years ago. How wonderful for students, parents, and

faculty to be able to live, learn, love, and grow in their faith and relationship with Jesus Christ.

Our Education Committee works to achieve our school’s mission by empowering students with

the ability to make positive lifelong choices and become disciples of God. We continue to

emphasize learning opportunities for all students based on our core values of Knowledge,

Worship, Respect, Service, and Community.

In order to maintain the level of excellence our school demonstrates academically and

spiritually, we are challenged to find a financial balance between income, expenses, and future

growth. In 2020-21, the cost of educating a child will be $8,000. Funding for this comes from the

three main income sources: tuition, parish investment, and 3rd source revenues (e.g.,

fundraising, grants, Mardi Gras, donations). We are blessed to have a Parish community which

supports Holy Spirit Catholic School through their prayers, gifts, and parish investment. We also

recognize school families and the many sacrifices they encounter by giving their child a faith-

filled education at Holy Spirit Catholic School.

We worked to design the 2020-21 school budget to address current and future financial needs

of the school while preparing for future growth.

Our goal is to continue to make Holy Spirit a viable educational choice for families where

students can grow in their faith. Please check out our new on-line registration procedures at

www.holyspiritknights.org.

The Education Committee has set a goal for the 2019-20 school year: to increase K-8th grade

enrollment from 168 students in 2019-20 to 185 students for the 2020-21, while retaining 90%

of 2019-20 families. Please help us reach our goal by registering your child. We look forward to

another year of working in harmony with Holy Spirit Catholic School families, parishioners, and

friends to enhance our school’s vision and mission.

The difference truly is inside!

Blessings,

Mike Zuleger Fr. Carl Schmitt The Education Committee

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Registration

2020-2021

Thank you for choosing Holy Spirit Catholic School for your child!

We are happy to have you as a part of our family!

Please complete the following online forms for the registration

process for 2020-2021. ____ Registration/Tuition Agreement/Health Permission

(Completed during online registration process)

____ $200 Registration Deposit (Pay Pal- After registration is completed)

___ Automatic Withdrawal Form (If choosing to make monthly payments)

Form is in your packet and must be returned by August 1st, preferably before the summer break. Ask the office if you need another copy.

_____ Immunization Form- New Students- Upload during online registration process Returning Students- Upload any updated immunizations during online registration process or turn them into the school office.

Tuition Assistance Forms & Handbooks are available on the school website. www.holyspiritknights.org

The Faculty and Staff of Holy Spirit Catholic School

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Registration Information 2020-2021

Tuition and Fees: Parish Member Non-Parish Milk Fee 3 year old Preschool (2 day T/Th) $1,225 $1,225 $30 3 year old Preschool (3 day M/W/F) $1,625 $1,625 $40 4 year PreK (5 days) a.m. session $1,975 $1,975 $70 All Day Kindergarten $3,100 $4,100 $70 Grades 1-8 (first 2 children in a family) $3,100 $4,100

Preschool 3 – 8th grade: 3rd child discount of $250 4th + child discount of $1250

Referral Bonus – Refer a new family and receive $150 for PreK, or $500 for K-8 tuition credit for the second semester of the current year.

Registration Deposit: $200/family (nonrefundable). Applied toward tuition if registered by Feb. 29, 2020.

Band Fee 4th – 8th grade $80/semester Athletics $40/per sport - $80 max per athlete per year SCRIP Credit $250 per family ($125 per family if oldest child is Pre3 or 4K) Parent Involvement Program $100 per family ($50 per family if oldest is in Pre3 or 4K) Preschool Hours: AM Session (Pre3 & 4K): 7:55-11:05 a.m. Kindergarten-Grade 8 Hours: 7:55 a.m.-3:15 p.m.

Childcare Program (available for registered students Pre3-Gr. 5) * Electronic Funds Transfer Required

Before School Care Available Monday through Friday 6:45 am-7:55 am The cost of the program is $7.00 a session per child. Lunch Bunch Available Monday through Friday 11:05 am-12:30 pm The cost of the program is $7.00 a session per child. After School Care Available Monday through Friday 3:15 pm -5:45 pm The cost of the program is $10.00 a session per child. (includes snack) Extended Care Available Monday through Friday 11:05 am-5:45 pm The cost of the program is $34.00/day per child. *These are contracted rates; there is an additional cost for drop in. All Inclusive Care A child attending both a PreK program and Extended Care five days a week is eligible to receive this discounted rate of $6,900/$39.20 per day (includes tuition & childcare, including early dismissals).

This rate includes care on all school days. The Non-school days, if needed, will be available at the $45 rate.

Non-School Days (3K – 5th Grade)

$45/All Day (6:45 am – 5:45 pm)

$34/Early Dismissal

(11:30 am - 5:45 pm)

(Max. 10 hrs/day) (NO legal holidays included)

minimum per session: 6 students

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W2796 County Road KK, Appleton, WI 54915 • 920-733-2651 • (Fax) 920-733-5440

Website: www.holyspiritknights.org • Email: [email protected]

SCRIP CREDIT Requirement

$250 per family ($125 for families with only a preschool student)

As part of your commitment to Holy Spirit Catholic School, your family is encouraged to participate in the

Parish SCRIP Program. This is optional, however, if you choose not to earn your credit requirement using

SCRIP it will be added to your tuition total.

How it will work:

We encourage you to use SCRIP to make your normal purchases of groceries, gas, clothing, and

dining out, etc. (there are many options to choose from).

The first $250 SCRIP credit earned for your family account each school year will go to the school as

Third Source Funding.

Credit earned over and above the $250 family minimum will be taken off of your family’s tuition balance.

If your family does not earn the $250 in SCRIP credit by April 1st, the remaining balance will need to

be paid with your family’s tuition balance.

If you have not been using SCRIP on a regular basis, this will be an opportunity for you to get in the

habit of using SCRIP for your weekly purchases. Once you reach the $250 SCRIP Credit requirement,

all future SCRIP credits will lower your tuition balance!

Benefits:

The SCRIP program benefits the parish and your family. Example: when you purchase a $100 gas

card offering a 5% credit, $2.50 goes to the parish and $2.50 goes to your family account…plus you still have a $100 gas card to use!

Using SCRIP doesn’t cost you anything; the money raised comes from the participating vendors.

You can purchase SCRIP for family and friends on your family account, allowing you the option to

have others help with your tuition. Others can purchase SCRIP and credit your account as well!

The two major fundraisers (Spirit of Christmas and Mardi Gras) do not have to plan for the raffle or

the costs associated with the raffle.

Rather than increasing tuition by more money per child to offset the former Third Source Funding,

the SCRIP Credit Minimum is still on a per family basis, which helps families with more than one child

enrolled at Holy Spirit Catholic School.

Holy Spirit Catholic School Education Committee

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W2796 County Road KK, Appleton, WI 54915 • 920-733-2651 • (Fax) 920-733-5440 Website: www.holyspiritknights.org • Email: [email protected]

HuTerra Rewards What is it? HuTerra Rewards lets you earn for your favorite nonprofits by shopping! When you shop at participating businesses they donate a percentage of your purchase to your chosen nonprofit. Simple, free, easy, and fun. Shop and earn at local stores

Use the My HuTerra app to find local stores that give HuTerra Rewards. On the home page tap Find LOCAL STORES and search by business or category to find businesses in your area that are giving the most HuTerra Rewards. Then shop, scan your receipt, and earn for your cause. Some local stores include; Darboy Corner Store, Manderfield’s Home Bakery, Pick ‘n Save, Piggly Wiggly, MotoMart,

Target, Walmart, and Simple Simon Bakery.

Shop and earn at online stores

We've added a fun new way to earn HuTerra Rewards! Shop hundreds of online stores! Along with earning at local stores you can now shop online at stores like Wal-Mart, Macy’s, Sam’s Club, Best Buy, and many others. Book your next vacation or hotel stay through the My HuTerra app to earn money for school/tuition. IMPORTANT: In order to RaiseUp for your cause while shopping online you must start shopping through the My HuTerra app. Items saved in your shopping cart prior will not qualify for cash back.

Start shopping online through the My HuTerra app. That's it! We'll be notified of your purchase and send your earnings on to your nonprofit.

Purchase Gift Cards

You can also purchase e-gift cards, and even send/share e-gift cards through the HuTerra app, to earn rewards. The e-gift cards are in put in your HuTerra ‘wallet’ to use on your smart phone at participating stores.

Benefits:

RaiseUp with HuTerra Rewards not only helps out the school, but also your tuition.

Staying in line with the scrip program, Holy Spirit is doing a 50/50 split with the school and your tuition. For example, go out to eat at the Darboy Club (Raise up to 3%), spend $100, pay how you normally would, then scan your receipt after, and $1.50 goes back to the school and $1.50 goes towards your tuition bill.

Why are we doing this?

This is not meant to be a competition or replace the scrip program, but another possible way to help lower your tuition and earn money for Holy Spirit School.

Unlike the scrip program, we are not doing a fundraising requirement for this program. You can use it if you wish to help earn money for the school and lower your tuition.

Shopping at Pick ‘n Save and forgot to order your scrip ahead of time, no problem!! Simply do your shopping, scan your receipt after and RaiseUp to 2% rewards for the school/tuition.

How do you get this to benefit your tuition?

When you find and select Holy Spirit School – Kimberly/Appleton on the app (Search Holy Spirit Appleton), you may select the school general fund or “Fund Our Students” and find a family name to which you wish to support. If you select a family name, the funds will be split between the school/family (50/50). Again, there is no requirement, so start saving today on your tuition!!

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W2796 County Road KK, Appleton, WI 54915 • 920-733-2651 • (Fax) 920-733-5440 Website: www.holyspiritknights.org • Email: [email protected]

Parent Involvement Program

Holy Spirit Catholic School requires 20 hours of parent involvement as part of having a child enrolled

at Holy Spirit. For families that only have a Pre3 or 4K child – only 10 hours. Research has proven

that parent involvement and student achievement go hand in hand. Parents may choose to pay the fee

or give 20 hours of their time to Holy Spirit. As a family, parents/guardians are billed $100 ($50 if you

only have a Pre3 or 4K child) as parent involvement fee. This fee may be worked off through

volunteer activities ($5.00 per hour). Parents are responsible for keeping track of the hours they work

and hours are credited on a quarterly basis. Please provide all dates, be specific in the details, and

turn them into the office. Some possibilities include:

Volunteering at Spirit of Christmas

Volunteering at Mardi Gras

Volunteering at the Golf Outing for Technology

Serving lunch*

Lunch supervision*

Concessions/gate at home games

Coaching/assistant coaching*

Room parent

Retreats/field trip chaperoning*

Building cleaning/organizing

Forensic coaching*

Lego League coach*

Girls on the Run coach*

Boy/Girl Scouts mentor*

Teacher appreciation lunch/supper (time spent to make food & money spent on items)

Classroom help (contact your child’s teachers)*

Committee members (Education Committee, Athletic, Fundraising, Finance, Home & School, Marketing, Policy, Technology)

Helping in the Library*

Attending school sponsored parent meetings

Student/Teacher Conferences

Volunteering at Parish/School Fish Fry

Simple Simon Bakery delivery organization

*Means must be VIRTUS trained Visit the Diocese of Green Bay website to view the schedule of VIRTUS trainings:

https://www.gbdioc.org/protecting-our-children/virtus

Not parent Involvement:

Attending band/choir concerts

Attending sporting events

Attending forensic or other competitions

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W2796 County Road KK, Appleton, WI 54915 • (School) 920-733-2651 • (Fax) 920-733-5440 • (Parish) 920-788-7640

Website: www.holyspiritknights.org • Email: [email protected]

Holy Spirit Catholic School

WISCONSIN PARENTAL CHOICE PROGRAM

Frequently asked Questions

What is the Wisconsin Parental Choice Program?

The Wisconsin Parental Choice Program (WPCP) allows students to attend a participating private school tuition-free if certain eligibility

criteria are met and the students are selected by the Department of Public Instruction (DPI). The private school, on behalf of the student’s parent or guardian, receives a state aid payment (voucher) for each eligible student. WPCP is a separate application process from the Holy

Spirit Catholic School tuition assistance application.

How do I know if we are eligible?

Families must meet income and student eligibility requirements.

Income eligibility: The prior year adjusted gross income (AGI) must be at or

below 220% of the federal poverty guideline (see chart). This would include

income of parents or legal guardians residing in the same household as the

student applicant. Family size includes parents or legal guardians and their

children by birth, marriage or adoption that reside in the same household as

the student applicant.

Student eligibility: Students new to Holy Spirit, coming from a public school or

home school in grades 4K through grade 8 are eligible. Returning Holy Spirit

students entering 4K-grade 8 are eligible for the 2020-21 and 2021-22 school

years. Thanks to the support from St. Mary Catholic Schools, Holy Spirit has

entered into a combined school agreement with SMCS to allow eligible returning

students to receive a voucher for two years. Beginning in the 2022-23 school

year, the returning Holy Spirit students entering 4K, kindergarten, and grade 1

will be eligible.

What expenses are covered by the WPCP vouchers?

The WPCP provides private schools with state-funded vouchers that cover full tuition, and registration. WPCP vouchers do not cover

co-curricular fees, equipment, transportation, after-school or summer care, elective school trips, classroom supplies or meals.

How and when do we apply?

Parents must complete the online Private School Choice Program application during the open application period, February 3-April 16, 2020

available at https://sms.dpi.wi.gov/ChoiceParent/. An email address is required to apply. In addition, parents must provide supporting

documentation directly to Holy Spirit Catholic School within the application period. Applicants are strongly encouraged to call Mike Zuleger

prior to completing the application.

What supporting documentation is required to complete the application?

Proof of income is required for all students new to WPCP. A signed copy of the federal 1040 is acceptable for verification. If taxes have not

been filed, please call Mike Zuleger (see below) to determine the best option for your family to qualify and provide documentation. It is

strongly recommended that you select the DPI method to verify income. The Department of Revenue (DOR) method is highly sensitive and

submissions using this method are final.

Proof of residency is required for all new and returning applicants. For a complete list of acceptable forms, refer to the DPI website (see

below). All supporting documentation must be submitted to the Holy Spirit Catholic School during the application period.

How are students chosen to participate in WPCP at Holy Spirit Catholic School?

The DPI will randomly draw from among eligible, valid applications. Parents are notified by the DPI via email in the summer regarding

acceptance or waitlist status.

Do I need to reapply for WPCP every year if my child receives a voucher at Holy Spirit Catholic School?

Yes, you must reapply each year online via the DPI website and supply residency documentation during the open application period.

Students who have received a WPCP voucher and reapply will be awarded a voucher each subsequent year regardless of income and grade.

If you have questions or would like to set up a private consult, contact Mike Zuleger at [email protected] or

920-733-2651 . More information on the program can be found at the Department of Public Instruction

website: http://dpi.wi.gov/sms/choice-programs.

Family

Size

Single Parent

2019* Income

Married

2019* Income

2 $ 37,202 XX

3 $ 46,926 $ 53,926

4 $ 56,650 $ 63,650

5 $ 66,374 $ 73,374

6 $ 76,098 $ 83,098

7 $ 85,822 $ 92,822

8 $ 95,546 $ 102,546

9 $ 105,270 $ 112,270

10 $ 114,994 $ 121,994

*2018 income can be used to qualify if you apply for the WPCP

prior to filing 2019 taxes.

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August

5 Early Childhood (Pre3-4K) Parent Meeting

17 New Teacher/Staff Orientation

18-24 Staff Professional Development In-Service

July 2020 25 Preschool 3 - Grade 8 Orientation January 2021

S M T W TH F S 26 First Full Student Day S M T W TH F S

1 2 3 4 1 2

5 6 7 8 9 10 11 September 3 4 5 6 7 8 9

12 13 14 15 16 17 18 7 NO SCHOOL - Labor Day 10 11 12 13 14 15 16

19 20 21 22 23 24 25 28 NO SCHOOL - Professional Development 17 18 19 20 21 22 23

26 27 28 29 30 31 24 25 26 27 28 29 30

October 31

8 & 13 Conferences

August 2020 28 End of Quarter 1 (Pre 3-Grade 5) February 2021

S M T W TH F S 29 NO SCHOOL - Professional Development S M T W TH F S

1 30 NO SCHOOL 1 2 3 4 5 6

2 3 4 5 6 7 8 7 8 9 10 11 12 13

9 10 11 12 13 14 15 November 14 15 16 17 18 19 20

16 17 18 19 20 21 22 8 Spirit of Christmas 21 22 23 24 25 26 27

23 24 25 26 27 28 29 11 VIP-Veterans Day/Early Dismissal/Prof. Develop. 28

30 31 18 End of Trimester 1 (Grades 6-8)

25-27 NO SCHOOL - Thanksgiving Break

September 2020 March 2021

S M T W TH F S December S M T W TH F S

1 2 3 4 5 17 K-Grade 8 Christmas Concert (1:15 pm & 6:00 pm) 1 2 3 4 5 6

6 7 8 9 10 11 12 23-31 NO SCHOOL - Christmas Break 7 8 9 10 11 12 13

13 14 15 16 17 18 19 14 15 16 17 18 19 20

20 21 22 23 24 25 26 January 21 22 23 24 25 26 27

27 28 29 30 1 NO SCHOOL - Christmas/New Year Break 28 29 30 31

4 Classes Resume

15 End of Quarter 2 (Pre 3-Grade 5)

October 2020 18 NO SCHOOL - Professional Development April 2021

S M T W TH F S 31 Catholic Schools Week Begins S M T W TH F S

1 2 3 1 2 3

4 5 6 7 8 9 10 February 4 5 6 7 8 9 10

11 12 13 14 15 16 17 5 Early Dismissal - Professional Development 11 12 13 14 15 16 17

18 19 20 21 22 23 24 6 Mardi Gras 18 19 20 21 22 23 24

25 26 27 28 29 30 31 9 Conferences 25 26 27 28 29 30

17 Ash Wednesday - School day

22 NO SCHOOL - Winter Break

November 2020 23 NO SCHOOL - Winter Break/Professional Develop. May 2021

S M T W TH F S S M T W TH F S

1 2 3 4 5 6 7 March 1

8 9 10 11 12 13 14 1 End of Trimester 2 (Grades 6-8) 2 3 4 5 6 7 8

15 16 17 18 19 20 21 5 Early Dismissal - Parish/School Fish Fry 9 10 11 12 13 14 15

22 23 24 25 26 27 28 19 End of Q 3 - Early Dismissal - Parish/School Fish Fry 16 17 18 19 20 21 22

29 30 23 24 25 26 27 28 29

April 30 31

2-9 NO SCHOOL - Easter Break

December 2020 4 Easter June 2021

S M T W TH F S S M T W TH F S

1 2 3 4 5 May 1* 2 3 4 5

6 7 8 9 10 11 12 10 Early Dismissal - Professional Development 6 7 8 9 10 11 12

13 14 15 16 17 18 19 13 K-Grade 8 Spring Concert (1:15 pm & 6:00 pm) 13 14 15 16 17 18 19

20 21 22 23 24 25 26 26 Last day of Preschool 3 MWF 20 21 22 23 24 25 26

27 28 29 30 31 27 8th Gr. Graduation/Last day of Preschool 3 TTH & 4K 27 28 29 30

28 Last Student Day - EARLY DISMISSAL

31 NO SCHOOL - Memorial Day

June Approved by Education

1* Potential snow day make up Committee 1/21/20

167 full days & 6 half days = total 173 contact days

Holy Spirit Catholic School

Calendar at a Glance 2020-2021

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W2796 County Road KK, Appleton, WI 54915 • 920-733-2651 • (Fax) 920-733-5440

Website: www.holyspiritknights.org • Email: [email protected]

PowerSchool Registration

It will be helpful to have these items handy:

❏ Parents’ work phone numbers

❏ Grandparent information including: addresses, emails, phone numbers

❏ Doctor Name, Phone

❏ Dentist Name, Phone

❏ Insurance Co. & Policy #

❏ Sacraments Completed- Dates, Places

❏ Have at least two emergency contacts with phone numbers

❏ Updated Immunization Record

NOTES:

Address of last school attended: Holy Spirit School- W2796 HWY KK Appleton, WI 54915

If you are a Holy Spirit Parish member: choose Kimberly as the site locator for the parish

New Students

Go to our website; www.holyspiritknights.org, under Registration – Enrollment – 2020-21 New

Student Registration link

Returning Students

Log into your PowerSchool Parent portal and click “Returning Student Registration”

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2020-2021

RETURNING student registration for the upcoming school year will be online through PowerSchool.

The process begins in your PowerSchool Parent Portal. You may already use your log-in to monitor your student’s lunch balance or grades, etc.

https://gbdioc.powerschool.com/public/

IF YOU HAVE AN ACTIVE ACCOUNT – YOU ARE ALL SET!

**When creating a new account: Enter ACCESS ID and Password provided in PowerSchool letter.

If you HAVE HAD an account, but do not

know/remember your username or

password, please use the link above and

click this to retrieve it using your email

address.

Contact the school office for questions

(920) 733-2651 or

[email protected].

If you DO NOT HAVE an account, use the

link above and click this to create an

account using your email address.

You will need the PowerSchool Password

Letter found in your packet. **

If you do not have a letter in your

registration packet, that means you already

have a parent account.

Contact the school office for questions

(920) 733-2651 or

[email protected].

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W2796 County Road KK, Appleton, WI 54915 • 920-733-2651 • (Fax) 920-733-5440 Website: www.holyspiritknights.org • Email: [email protected]

Automatic Withdrawal Authorization Form - Tuition

New Change Cancel

I authorize Fox Communities Credit Union / Holy Spirit School Tuition

To debit my Checking Savings (please check one)

Monthly on the 1st Monthly on the 15th Weekly

In the amount of $__________________ With a start date of _____________________ From (your account):

Name on Account: ______________________________________________________________ Financial Institution: ____________________________________________________________ Routing Number: _______________________________________________________________ Account Number: _______________________________________________________________ ** Please provide a voided check if account is a checking account.

These funds will be received by Fox Communities Credit Union, routing number 275977256, For Credit To:

Business Name: Holy Spirit Parish Account Number: _______________________________________________________________ This authorization will remain in effect until my 2020-21 tuition is paid in full. Holy Spirit Parish is not able to change the authorization amount unless a new signed form is filled out. Holy Spirit Parish will notify Fox Communities Credit Union in a timely manner to revoke the authorization once the tuition is paid in full. If you decide to change your payment option, you must notify the business office via email or letter of your new option and your desire (and date) to terminate this authorization form. In case of error, Fox Communities Credit Union must be contacted no later than 60 days after you receive your financial statement on which the error appeared. ________________________________ _______________________________ Signature Date

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W2796 County Road KK, Appleton, WI 54915 • 920-733-2651 • (Fax) 920-733-5440 Website: www.holyspiritknights.org • Email: [email protected]

Automatic Withdrawal Authorization Form – Child Care

New Change Cancel

I authorize Fox Communities Credit Union / Holy Spirit Child Care

To debit my Checking Savings (please check one)

Monthly on the 1st Monthly on the 15th Weekly

In the amount of $ __________________ With a start date of ____________________ From (your account):

Name on Account: ______________________________________________________________ Financial Institution: ____________________________________________________________ Routing Number: _______________________________________________________________ Account Number: _______________________________________________________________ ** Please provide a voided check if account is a checking account.

These funds will be received by Fox Communities Credit Union, routing number 275977256, For Credit To:

Business Name: Holy Spirit Parish Account Number: _______________________________________________________________ This authorization will remain in effect until my 2020-21 account is paid in full. Holy Spirit Parish is not able to change the authorization amount unless a new signed form is filled out. Holy Spirit Parish will notify Fox Communities Credit Union in a timely manner to revoke the authorization once the tuition is paid in full. If you decide to change your payment option, you must notify the business office via email or letter of your new option and your desire (and date) to terminate this authorization form. In case of error, Fox Communities Credit Union must be contacted no later than 60 days after you receive your financial statement on which the error appeared. ________________________________ _______________________________ Signature Date