2018-2019 Portland Kinderschule Application and Agreement
2018-2019 Portland Kinderschule (PKS) Application Form
We are full for next year! Please submit this form to be added to the wait list. Our membership coordinator will be in contact about when to pay the non-refundable registration fee of $120 for new students and $100 for returning students as well as $5 for each criminal background check form submitted. Payment can be made via Zelle (e-mail cotreasurer@portlandkinderschule.com), bank transfer (contact us at info@portlandkinderschule.com for the account number), or check payable to Portland Kinderschule and mailed to Portland Kinderschule 2195 SW Vermont St. Portland, OR 97219. Discounts are not given for missed days, vacation, illness or emergency closure.

Applications are processed in the order they are received. Portland Kinderschule does not discriminate on the basis of race, color, ethnicity, gender, sexual orientation, disability, religion, language ability, or national origin.

Part 1: Contact Information
Child's First Name *
Your answer
Child's Last Name *
Your answer
Name child prefers, if different from above
Your answer
Child's Birth Date (Please contact us if your child will not be 3 by September 1, 2018, for approval.) *
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Parent/Guardian #1 Name *
Your answer
Parent/Guardian #1 Cell Phone *
Your answer
Parent/Guardian #1 Other Phone
Your answer
Parent/Guardian #1 E-mail *
Your answer
Parent/Guardian #1 Address *
Your answer
Parent/Guardian #1 Occupation/Employer *
Your answer
Parent/Guardian #2 Name *
Your answer
Parent/Guardian #2 Cell Phone *
Your answer
Parent/Guardian #2 Other Phone
Your answer
Parent/Guardian #2 E-mail *
Your answer
Parent/Guardian #2 Address (if different)
Your answer
Parent/Guardian #2 Occupation/Employer *
Your answer
Would you like to enroll your child 3, 4, or 5 days? *
Please select your preferred days of enrollment. *
Required
Are you interested in our after school program (1-3 pm), which is a partner program operated by the Sophie Scholl Schule? *
How did you hear about Portland Kinderschule? *
Your answer
Part 2: Membership Agreement
Please read the agreement in its entirety here: https://goo.gl/mFoHqa and then answer the questions below. As parent/guardian, do you agree to
1. Assist in the classroom as a parent helper and be available as an alternate? *
2. Attend orientation and general meetings 3 to 4 times per year? *
3. Take responsibility for a job and actively participate in the school? *
4. Participate in fundraisers and meet your family's “fair share” amount? *
5. Support German language in the classroom with children, teacher(s) and other parents whenever possible? *
6. Provide a completed immunization record for your child prior to the beginning of school? *
With PKS' Schedule Changes and Cancellation Policy? *
Grant Portland Kinderschule the right to use all pictures and videos of Student(s) that may be obtained by Portland Kinderschule during any time Student(s) or any family members or guests of Student(s) are involved with school activities? *
Grant permission for Student to participate in PKS fieldtrips? *
Agreement and Release: Parent/Guardian warrants, represents, and agrees that Student(s) is in good physical and mental condition, and has no disability, impairment or ailment that would prevent Student(s) from engaging in all activities related to the classes for which he/she is registered. Parent/Guardian expressly agrees that participation in all of the Portland Kinderschule classes and facilities are at parent/guardian and Student’s sole risk. By signing this Agreement, Parent/Guardian waives, releases, and forever discharges Portland Kinderschule, its agents, employees, instructors, and/or staff for any and all injuries, damages, and/or loss which may be sustained by Student(s), any member of Parent/Guardian family, and/or any guests of Student or Parent/Guardian arising out of or connected with the use of any of the services or facilities of Portland Kinderschule or the premises on which Portland Kinderschule is located; Parent/Guardian further agrees that Portland Kinderschule is not liable for any demands, claims, damages, actions or causes of action whatsoever, to person or property, arising from or connected with such use. In addition, by marking "yes" Parent/Guardian hereby represents that Parent/Guardian has never been convicted of nor is under indictment for any crime involving violence or force or sex-related crimes involving a minor or adult. *
Tuition Payment Policy and Late Charges
2018-2019 tuition is $335 for 3 days/week, $386 for 4 days/week, $438 for 5 days/week. 2018-2019 Fair Share will be determined by the Board in August.

Tuition Payment Date and Late Charges: The first tuition payment is due August 1st. After that, tuition must be paid in full by the 15th of each month until May 15th. Electronic deposits preferred. Discounts are not given for missed days, vacation, illness, or inclement weather cancellations. Payments made four days or more following the due date will be considered late, and a $15.00 late fee will be charged each week that it remains unpaid. PKS is entitled to all costs of collection, including reasonable attorneys’ fees in the event of the parent’s/guardian’s default of this Agreement. A 10% sibling discount applies to each additional child you enroll in PKS. The child registered with the highest number of days per week pays full tuition.

A limited amount of need-based financial aid may be available. Please contact us for more information.

Parent/Guardian acknowledges that he/she has read and understands the Application, Tuition Policy, and Membership Agreement as stated above and agrees to its terms. (Please type name and date) *
Your answer
Part 3: Teacher Questionnaire
Returning students: please only complete updated information. Otherwise, type "no change".
Child's birthplace *
Your answer
Is your child *
Sibling(s) name(s) and age(s) *
Your answer
1. Who does your child live with? (parents, grandparents, etc.) *
Your answer
2. What benefits do you expect to gain from a German immersion program for your child? For yourself? *
Your answer
3. What are some concerns you have about enrolling your child in an immersion program? *
Your answer
4. What is your interest in or knowledge of German culture and/or the German educational system? *
Your answer
5. What are some of the reasons you would like your child to attend PKS? What are your main goals for your child for this school year? *
Your answer
6. Which language(s) are spoken by the parents with the child? *
Your answer
7. Which language does the child speak while playing with his or her siblings (if any)? *
Your answer
8. Which language(s) are spoken at the dinner table? *
Your answer
9. Which language(s) are spoken in the car on the way to school or other activities? *
Your answer
10. What are some of your child’s favorite play activities? *
Your answer
11. What are your child’s strengths: behavioral, social and/or cognitive? *
Your answer
12. What are your child’s challenges: behavioral, social and/or cognitive? *
Your answer
13. Does your child have special needs (learning, social, physical, emotional) that require assistance at school? *
Your answer
14. Has your child’s growth and development been as expected by you and his or her physician? Please include anything that would be helpful to us in working with your child. *
Your answer
15. Does the child have specific tasks or jobs to do at home? What are his or her regular responsibilities? *
Your answer
16. How often does your child currently go to the bathroom unassisted (circle one)? *
17. What important events have occurred for your son or daughter during the recent past (a move, child’s or family illness, births, deaths, divorce or separation, other)? *
Your answer
18. Is the child currently in any play groups, classes, or care centers? If yes, where, how many days and for how long? How long has child been attending? Please also list school name and number. *
Your answer
19. Has your child ever received occupational or speech therapy? If yes, when and for how long? *
Your answer
20. From what activities does your son or daughter gain self-confidence? *
Your answer
21. Does your child have any fears (dark, strangers, animals, etc.) or nervous habits (nail biting, sucking fingers, etc.)? Please describe them and how you handle these. *
Your answer
22. Does your child have any pets (names and types)? *
Your answer
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