Delgado Community College



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Controller’s Office

615 City Park Avenue

New Orleans, LA 70119

Phone: (504) 483-4675

Fax: (504) 483-4033

Childcare Promissory Note

Delgado Community College and _____________________________ enter into this agreement to pay for unpaid childcare (day care) balances as of ____________________. Payments must be made in accordance with the below payment schedule until paid in full.

I authorize Delgado Community College to deduct (after payment of tuition and other educational related charges) from my Pell Award, GSL and/or scholarship all monies owed to the College for Day Care Services. If this does not cover the full past due balance, the following payment schedule will be placed into effect:

Payment Schedule: Payments of $_______________per month are due on the 15th of each month for the following months________________________through____________________. If payment is not received by the 15th of the month, a $5 late fee will be added to my account balance. If payment is not received by the 20th of the month, my child will not be allowed to return to the Day Care Center.

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Print Name Approval:

________________________________________ _____________________________

ID # Director of Accounts Receivable

________________________________________ _____________________________

Signature Date Date Approved

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I understand that failure to meet all of the above payment deadlines will result in my child being withdrawn from the Day Care Program and the account balance submitted to a collection agency or filed with the District Attorney’s Office. All fees associated with this placement will be added to my account. I understand that if I am a faculty or staff member and I default on my Promissory Note, I authorize Delgado Community College to deduct the monthly payments from my bi-weekly payroll check. If I resign from the College and have an unpaid debt, the College will deduct the balance from my final paycheck.

I also understand that all current charges must be paid on time or my child will not be allowed to return to the Day Care Center.

I understand that the College will deduct my balance from the first available source, (Pell, GSL or scholarship) and I will receive the balance in the form of a refund check.

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