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	School Contact Information | 
  
  
    | Name of School | * |  |  |  | 
  
  
    | Street Address | * | 
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    | City | * |  |  |  | 
  
  
    | State | * | 
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    | Zip Code | * |  |  |  | 
  
  
    | Main School Phone | * |  |  |  | 
  
  
    | Total Enrollment | * |  |  |  | 
  
  
    | Head of School Name | * |  |  |  | 
  
  
    | Head of School E-mail Address | * |  |  |  | 
  
  
    | Head of School Direct Phone | * |  |  |  | 
  
  
    | Admissions Director Name | * |  |  |  | 
  
  
    | Admissions Director E-mail Address | * |  |  |  | 
  
  
    | Admissions Director Direct phone | * |  |  |  | 
  
  
    | Admissions Director Name |  |  |  |  | 
  
  
    | Admissions Director E-mail Address |  |  |  |  | 
  
  
    | Admissions Director Direct Phone |  |  |  |  | 
  
  
    | Business Office Contact Name |  |  |  |  | 
  
  
    | Business Office Contact E-mail Address |  |  |  |  | 
  
  
    | Business Office Contact Direct Phone |  |  |  |  | 
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	Enrollment Size & Membership Fee Chart
	
		
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							| Enrollment Size | Membership Fee |  
							| >75 | $500 |  
							| 75-149 | $2,435 |  
							| 150-224 | $4,905 |  
							| 225-299 | $6,890 |  
							| 300-499 | $8,785 |  
							| 500-699 | $10,400 |  
							| 700-899 | $11,990 |  
							| 900-1,099 | $12,830 |  
							| 1,100-1,299 | $13,300 |  
							| 1,300-1,490 | $13,900 |  
							| 1,500+ | $14,570 |  
							| Auxiliary | $1,590 |  |  |  
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	Payment OptionsPay Online 
 
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    | Enrollment Size and Membership Fee |  |  |  |  | 
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	ACH Wire Transfer:Check: payable to EARLY STEPS, mailed to satellite office:JPMORGAN CHASE BANK
 Routing number:  021000021
 Account number: 119005093
 EARLY STEPS
 c/o Jacqui Pelzer
 10 Waterside Plaza – Apt 6J
 New York, New York 10010
 
 Payment is due on OCTOBER 15, 2025.
 
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	AgreementChecking the box below serves as confirmation of your school's membership in Early Steps for the 22-23 school year and agreement to pay dues in accordance with enrollment size. | 
  
  
    | Name of School | * |  |  |  | 
  
  
    | Date | * | 
    
    
        Choose Date
          
            
    
    
    
        
            
            
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    | Signature (please print) | * |  |  |  | 
  
  
    | Agree | * |  |  |  | 
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