Clone of DCS 1 DEC Registration 2019-2020 thread 1843216a

Phoenix Extended Care (DEC) Application
Discovery Charter School's Extended Care Program

Discovery Extended Care (DEC) is a true extension of the Discovery philosophy and incorporates positive discipline, student-driven enrichment, and inquiry-based activities facilitated by engaged, well-trained professionals.

We are committed to providing a safe, comfortable environment where students can play, study, explore, and create.

Applications will be accepted up to June 30th. Priority placement will be given to families that sign up for a 5 day a week program (in the order that they are received). All other applications will be placed in the following order 4 day, 3 day, 2 day, and 1 day, in the order they are received. Applicants will be notified if they have received a placement or if they have been waitlisted during the first week of July.

Your application fee will be refunded upon request if you are not placed, however if you would like to keep your place in line on the waitlist we will hold the fee.
Review Application Packet
Application Packet*

I have read and agree to the Application Packet
Number of Students Applying *

Emergency Contact/Pick Up Information
Emergency Contact Information

In case of an emergency, if neither parent/guardian can be located, please notifiy the following.

Parents will always be contacted first. Please provide other contacts in case the parents can not be reached. This is to be used in emergencies only.
Emergency Contact 1*

First NameLast Name
Relationship to Child*
Primary Number *
Alternate Number
Emergency Contact 2*

First NameLast Name
Relationship to Child*
Primary Number *
Alternate Number
Child Release Authorization

No adult other than the parents/guardians or the individuals listed below may pick up your child(ren) from the Discovery Extended Care Program without prior written consent.
Name 1

First NameLast Name
Relationship to Child
Primary Number
Alternate Number
Name 2

First NameLast Name
Relationship to Child
Primary Number
Alternate Number
Name 3

First NameLast Name
Relationship to Child
Primary Number
Alternate Number
Name 4

First NameLast Name
Relationship to Child
Primary Number
Alternate Number

Parent & DEC Payment Information
Parent and Payment Information
Parent 1 Name*

First NameLast Name
Parent 1 Email*
example@example.com
Primary Phone Number*
Alternate Phone Number
Parent 2 Name

First NameLast Name
Parent 2 Email
example@example.com
Primary Phone Number
Alternate Phone Number
Extended Care Monthly Payment Information

Methods of Payment

Payments may be made by cash, check, money order, or via credit card. Returned checks will incur a service charge of $25, in addition to any bank fees. Thereafter, DEC would require that future payments be made using cash, money order, or credit card.

There is a convenient on-line form to easily setup automatic monthly credit card payments, If paying by check, make them payable to Discovery Charter School and submit payments to the tuition box located in the DEC Program Office.

We do offer a 5% discount if enrolling for the entire year (Aug-June) and you want to pay for the entire year.

Late Payments and Fees

Please ensure that payment is received on the 15th day of each calendar month. In the event that payment cannot be made on the due date, please contact the DEC Director at extendedcare@discoveryk8.org to discuss available options. Payments that are more than 10 days past due will incur a late fee of $50; repeated past due statements may result in the termination of the enrollment contract.

Financial Assistance

We are community-focused and will work with our school administrators and staff to ensure that every child -- regardless of financial circumstances -- receives quality care. To that end, financial assistance is available. If you would like more information on financial assistance, please check the box below.

Once we notify you that a space has become available you will have two business days to submit the completed financial aid application that we will provide, along with two of your most recent pay stubs or a letter from your employer that includes income information. Please make sure you have these items available so you will be prepared when we notify you.
Do you want to receive more information about financial assistance?

YesNo

Application Payment Information
Application Payment Information
Total Monthly Amt Due
Total Application Fee
The application fee is $50 for 1 student $75 for 2 students and $100 for 3 students.

This fee can be paid by credit card or e-check. To pay by e-check click the e-check button below.
Donation Name
Payment Method*

Pay with Credit Card

Total Amount Due

USDApplication Fee

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Submission of this form does not gurantee a spot into the program.
Should be Empty:

Phoenix Extended Care (DEC) Application