Discovery Preschool Application

Thank you for your interest in Discovery Preschool! We are excited that you are planning to join our preschool family. Please notice that at this time we are only accepting applications for the 2016-2017 school year. If you have any questions please contact Melissa Hammond at or at 509-527-2252. Thank you and God bless!
Discovery Preschool is offered to potty trained child age 3-5. Our hours are 8:00–11:30 each week day, with an option extended lunch period which ends at 12:15.
  Please specify when you would like your child to attend preschool.
Starting Date:
* Choose the days of the week you would like to send your child:
Entrance Fee:
Child Information
* Full Name of Child: (Last, First, Middle Initial)
* By what name is your child called?
* Child’s Birth Date:
* Child’s Gender:
  Child’s Home Address:
* City: * * Zip/Postal Code:
* Child’s Home Phone Number:
Family Information
  Contact Information:
* Mothers Name: * Fathers Name:
* Home Phone:
Mothers Cell Phone(s): Fathers Cell Phone(s):
* Home Address:
* Names and ages of other children in family:

About Your Child
* How would you describe your child? (Active, impulsive, shy, assertive)

* What would you hope a preschool experience will provide for your child?

* Is there any physical or emotional problem which might interfere with your child’s successful adjustments to school?
(Allergies, unusual behavior, etc.)

* Has your child attended a preschool/daycare program in the past? Please provide the name and location of the program.

* How did you learn of our preschool program?

Additional Information
* Names and phone numbers of all PERSONS AUTHORIZED to take my child from the Discovery Preschool:
(Include Parents’ Names)

* In case of emergency, who should we contact if we are unable to reach parents? Include Name and Phone Numbers:

* Who is/are responsible for paying the Preschool charges?
Please Select a Payment Method

* Online Payment Options:      
US or International payment
This is an agreement between WALLA WALLA UNIVERSITY, a Washington non-profit Organization as creditor and the Parent/Responsible Party/Debtor named on the reverse.

In this agreement the words “you”, “your”, and “yours: mean the Parent/ Responsible Party/Debtor. The word “account” means the account that has been established in your name to which charges are made and payments credited. The words “we’, “us”, and “our’ refer to WALLA WALLA UNIVERSITY.

MONTHLY STATEMENT: If you have a balance on your account, we will send you a monthly statement. It will show separately the previous balance, any new charges to the account, the finance charge, if any, and any payments or credits applied to your account during the month.

PAYMENTS: Unless other arrangements are approved by us in writing, the balance on your statement is due and payable when the statement is issued, and is past due if not paid by the end of the month.

CHARGES TO THE ACCOUNT: We shall have the right to cancel your privilege to make charges against your account at any time.

FINANCE CHARGE: A FINANCE CHARGE will be imposed on each item of your account which has not been paid within thirty (30) days of the time the item was added to the account. The FINANCE CHARGE will be computed at the rate of one percent (1%) per month or an ANNUAL PERCENTAGE RATE of twelve percent (12%). The FINANCE CHARGE is computed by multiplying the sum of all charges that are 30 days past due by one percent (1%) to obtain the periodic finance charge.

DEFAULT: You will be in default if you do not pay your account in accordance with an agreement approved by us in writing. If we do not have a written agreement, you will be in default if you do not pay your statement balance in full by the end of the month following its issue date. Default means that we can demand immediate
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payment of the full account balance. If we have to refer your account to a collection agency, you agree to pay all the collection costs which are incurred. If we have to refer collection of the balance to a lawyer, you agree to pay all lawyers’ fees which we incur plus all court costs.

CREDIT HISTORY: You give us permission to check your credit and employment history and to answer questions about your credit experience. We have the option to report your account status to any credit reporting agency such as credit bureau.

EFFECTIVE DATE: Once you have signed this agreement, you agree to all of the terms and conditions contained herein and agreement will be in full force and effect.
Enrollment of this child in the WWU Discovery Preschool grants the staff permission to allow such child to be observed and/or filmed in conjunction with approved university classes, program promotion including web postings, and scheduled activities.
* I understand and agree to the terms and conditions that are
printed on this form. By initialing this form, you acknowledge use of your electronic signature as shown:
Initials:   Fri May 27, 2016 3:21 am
  * Response required