Please enroll the
BaltimoreInternational Academy
4410 Frankford Avenue
Baltimore, MD 21206
Please enroll the following students in the Baltimore International Academy
Extended Care Program for the 2016-2017 school year.
Child’sFull Name / Gender / Grade in
2016-2017 / Child’s Language / Birth Date / Check Days of the Week to be Enrolled
M / Tu / W / Th / F
Please provide the following information
First Name / Last Name / Contact InformationFather / Daytime Phone:
Cell Phone:
Email:
Mother / Daytime Phone:
Cell Phone:
Email:
Guardian* / Daytime Phone:
Cell Phone:
Email:
Name & Mailing Address of Primary Contact: ______
______
* In the case of guardianship, please explain the relationship to the child(ren) and provide name and city ofresidence of natural parents. Parents/Guardians are responsible for updating contact information with theEnrichment Program Director in writing.
If you have any questions regarding the Enrichment Program or this form,please contact Director- Kali Merritt at 443-602-5948 or the Business Office at 443-278-9417.
Maximum Total Discount is 15%
BIAEnrichmentProgram Annual Fees
After School Care Monthly Cost # of Students # of Months(Sept-June)Subtotal
Full-Week $ 185 x ____ x_____ = ______
3 Days per Week$ 145x____ x_____ =______
2 Days per Week $ 105x____ x_____= ______
Before School Care
Full-Week $75 x ____ x_____ = ______
3 Days per Week$60 x ____ x_____= ______
2 Days per Week $50x____ x_____= ______
Total Cost(Add all lines above)=______
(Maximum Total Discount is 15%)
Less Discount (10%)
For Auto Debit/Payment in Full-______
Less Discount (5%)
For Early Registration by July 31-______
Less Discount
Sibling Discount:
2.5% for the first 2, 5% for 3 or more -______
Subtotal=______
Divided by 10 = Monthly Pmt Amt______
(or divided by # of months left in school year)
Less 2 Month Deposit= ______
(Deposit is Nonrefundable and will be applied to the student’s account
at the end of the school year if the child is still in the program)
Balance Owed for School Year =______
(After Deposit)
____(initial) Fee Deposit:A deposit equal to 2 months of the tuition is due pending acceptance and enrollment into the program. This deposit is nonrefundable, but will be applied to your child’s account at the end of the school year IF your child is still enrolled in the Enrichment Program. A notice of 10 business days must be submitted in writing to the Business Office in order to withdraw from the program and stop billing. The date of the written notice plus ten business days will be used as the date of official withdrawal. If the child is withdrawn from the program without written notice, the normal fees will continue to be charged to the child’s account.
____(initial) Fee: Fees are based on an annual schedule. No refunds will be given in the case of illness, absence, suspension, holidays, or school closing or delays. Additional fees may be charged for special enrichment activities.
____(initial) Payment: Payment, minus the deposit, may be made in one of four ways: payment in full up front, monthly payments, weekly payments, or monthlypayments scheduled with regular AUTO DEBIT. A 10% discount is given to all AUTO DEBIT payments. Payment of all fees must be current. All accounts with anunpaid balance will be considered delinquent. Any family whose account is not current will not be permitted to usethe service until the account is made current. After that time any missed payment may result in the student’spermanent dismissal. All fees must be paid by check, cash, or money order. No third-party checks can be accepted. Students who register for Extended Care before July 31, 2016(including receipt of deposit and Auto Debit form) will be given a 5% discount that can be combined with the AUTO DEBIT discount for a total discount of 15%.
____(initial) Returned Checks: As a result of a returned check, your account will be assessed a charge for the amount of thereturned check, as well as a $25.00 returned check fee. Additionally, the use of personal checks for payment may berevoked and future payments will only be accepted in the form of cash, money order, or Cashier’s check.
____(initial) Withdrawals: Deposit and fees are nonrefundable. Charges will be computed to the day of withdrawal plus 10 school days. In the case of early withdrawal, the deposit will not be applied to the student’s account and will not be refunded.
____(initial) Dismissal: If a student is permanently dismissed for any reason, the parents/guardians remain responsible forensuring payment is made for services rendered while their child was still in attendance. Charges will be computedto the day of withdrawal plus 10 school days.
____(initial) Program Changes: Changes requested in program scheduling must be submitted in writing to the Extended CareDirector for approval before any changes can be made with the Financial Manager.
____(initial) Billing Changes: Request for changes in billing must be made in writing and submitted to the Financial Manager.
____(initial) Hours of Service: Mondays –Fridays7:00am-8:00am and2:50pm-6:00pm. Extended Care isnot available during school holidays, vacations, or days-off. In the case of late starts, Before School Extended Carewill begin one hour before the postponed start. After School Extended Care will not be offered on scheduled earlydismissal school days. In the event of severe weather conditions, the Extended Care Director may ask parents topick-up children earlier. All school delays and cancellations follow Baltimore City notices. Refunds will not be given when school is closed due to inclement weather or other unforeseen issues.
____(initial) Late Pick Up: If a child is picked up after 6:00pm, a late fee of $1 per minute will be assessed. Late fees must be paid by cash or check at the time of pick-up. No exceptions.
____(initial) Parent/Student Handbook: All general discipline policies outlined in the BIA Parent/Student Handbook apply.
____(initial) Sick Policy: Any child with a fever, vomiting, or other serious health conditions must be picked up by a parent orother authorized individual and will not be allowed to attend Extended Care. The same health rules apply to Extended Care as to regular school attendance. Refunds will not be given for time missed due to illness or other health conditions.
____(initial) Continual Conflict: In the event that a child or the parent of a child continually causes disagreements, conflicts,strife, or arguments, the child shall be dismissed from the extended care program without legal recourse. Withdrawaland dismissal policies apply.
____(initial) Legal Fees: All legal fees, collection fees, attorneys’ fees, collection costs and any additional fees incurred by theschool in an effort to settle disputes connected to this account shall be the sole responsibility of the parent orguardian for which this agreement is made.
____(initial) Arbitration: If a legal issue, disagreement, conflict, problem, injury, injustice, or any other legal dispute shouldarise between the school or one of its agents and a child or parent of a child, it shall be referred to binding arbitrationwith a non-partial arbitration party (to be mutually-agreed upon) for the settling of all issues.
Payment Plan Notification Form
2016– 2017School Year
(Maximum Total Discount is 15%)
Balance Due: (from worksheet, p.2)
Balance Owed After Deposit & Discounts: $ ______
Check one payment option:
______I intend toPay in Full (10% Discount):
______I intend to make Monthly Payments: A 2-monthnonrefundable deposit of the full fee, and monthly
payments of _____ beginning September 1, 2016, or first day of enrollment. All payments must be completed no later than April 30, 2017.
______I intend to make Weekly Payments: A 2-monthnonrefundable deposit of the full fee and weekly
payments of _____beginning September 1, 2016, or the first day of enrollment. All payments must be completed no later than April 30, 2017.
______I intend to pay using AUTO DEBIT: A 2-monthnonrefundable deposit of the full fee and the remaining with my monthly AUTO DEBIT payments. (Monthly payments are from September 2016 (or first month of enrollment) throughApril 2017. Please fill out the AUTO DEBIT authorization form and attach it with your registration. If you have any questions, please contact Kali Merritt at 443-602-5948 or theBusiness Office at 443-278-9417.)
I have read the parental and payment agreementand fully agree to abide by the policies as set forth in its entirety. Iunderstand that this parental/payment agreement will be strictly enforced. I agree to pay all financial obligations toBaltimoreInternationalAcademy promptly and in a timely manner. I agree to uphold the rules and regulations ofBaltimoreInternationalAcademy as set forth in the Parent/Student Handbook. Also, in signing this agreement, I giveconsent for my child to participate in all regular Enrichment Program activities unless I notify the administration in writingotherwise. I understand the school will keep me informed of special activities well in advance. I also agree not tobring/leave my child in extended care if full payment of my balance has not been made by the due date.
Name of Responsible Party (please print):______
Signature: ______Date: ______
Please return this form to the school office, Attention: BIA Enrichment Program.
Parent Copy – Please Keep for Your Records
Fee Deposit:A deposit equal to 2 months of the tuition is due pending acceptance and enrollment into the program. This deposit is nonrefundable, but will be applied to your child’s account at the end of the school year IF your child is still enrolled in the Enrichment Program. A notice of 10 business days must be submitted in writing to the Business Office in order to withdraw from the program and stop billing. The date of the written notice plus ten business days will be used as the date of official withdrawal. If the child is withdrawn from the program without written notice, the normal fees will continue to be charged to the child’s account.
Fee: Fees are based on an annual schedule. No refunds will be given in the case of illness, absence, suspension, holidays, or school closing or delays. Additional fees may be charged for special enrichment activities.
Payment: Payment, minus the deposit, may be made in one of four ways: payment in full up front, monthly payments, weekly payments, or monthly payments scheduled with regular AUTO DEBIT. A 10% discount is given to all AUTO DEBIT payments. Payment of all fees must be current. All accounts with an unpaid balance will be considered delinquent. Any family whose account is not current will not be permitted to use the service until the account is made current. After that time any missed payment may result in the student’s permanent dismissal. All fees must be paid by check, cash, or money order. No third-party checks can be accepted. Students who register for Extended Care before July 31, 2016 (including receipt of deposit and Auto Debit form) will be given a 5% discount that can be combined with the AUTO DEBIT discount for a total discount of 15%.
Returned Checks: As a result of a returned check, your account will be assessed a charge for the amount of the returned check, as well as a $25.00 returned check fee. Additionally, the use of personal checks for payment may be revoked and future payments will only be accepted in the form of cash, money order, or Cashier’s check.
Withdrawals: Deposit and fees are nonrefundable. Charges will be computed to the day of withdrawal plus 10 school days. In the case of early withdrawal, the deposit will not be applied to the student’s account and will not be refunded.
Dismissal: If a student is permanently dismissed for any reason, the parents/guardians remain responsible for ensuring payment is made for services rendered while their child was still in attendance. Charges will be computed to the day of withdrawal plus 10 school days.
Program Changes: Changes requested in program scheduling must be submitted in writing to the Extended Care Director for approval before any changes can be made with the Financial Manager.
Billing Changes: Request for changes in billing must be made in writing and submitted to the Financial Manager.
Hours of Service: Mondays - Fridays 7:00-8:00am and 2:50-6:00pm. Extended Care is not available during school holidays, vacations, or days-off. In the case of late starts, Before School Extended Care will begin one hour before the postponed start. After School Extended Care will not be offered on scheduled early dismissal school days. In the event of severe weather conditions, the Extended Care Director may ask parents topick-up children earlier. All school delays and cancellations follow Baltimore City notices. Refunds will not be given when school is closed due to inclement weather or other unforeseen issues.
Late Pick Up: If a child is picked up after 6:00pm, a late fee of $1 per minute will be assessed. Late fees must be paid by cash or check at the time of pick-up. No exceptions.
Parent/Student Handbook: All general discipline policies outlined in the BIA Parent/Student Handbook apply.
Sick Policy: Any child with a fever, vomiting, or other serious health conditions must be picked up by a parent or other authorized individual and will not be allowed to attend Extended Care. The same health rules apply to Extended Care as to regular school attendance. Refunds will not be given for time missed due to illness or other health conditions.
Continual Conflict: In the event that a child or the parent of a child continually causes disagreements, conflicts, strife, or arguments, the child shall be dismissed from the extended care program without legal recourse. Withdrawal and dismissal policies apply.
Legal Fees: All legal fees, collection fees, attorneys’ fees, collection costs and any additional fees incurred by the school in an effort to settle disputes connected to this account shall be the sole responsibility of the parent or guardian for which this agreement is made.
Arbitration: If a legal issue, disagreement, conflict, problem, injury, injustice, or any other legal dispute should arise between the school or one of its agents and a child or parent of a child, it shall be referred to binding arbitration with a non-partial arbitration party (to be mutually-agreed upon) for the settling of all issues.
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