Hoja De Registro
Enviado por yeye960 • 27 de Diciembre de 2012 • 385 Palabras (2 Páginas) • 490 Visitas
Registration Form
Student Information
First Name ________________________ Last Name_____________________
Date of Birth ______________ Details we need to be aware __________________________
Postal Address _________________________________________________________________
Contact Number:_________________________ Email ________________________________
Name of Mother :_________________________ Name of Father________________________
Is any other adult sharing class with your child? ____I yes, Name ________________
Course Information
Course ________________ Day ___________ Time ____________
Start Date ______________ Duration of Class _______
# of Classes per session ______
Teacher's name ____________________________
*NO CLASS ON FOLLOWING DATE:
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Cost of course (materials, taxes & tuition included)
Total: $____________- discount (when apply) ___________ =______________
____ Cash
____ Check: Please make check Payable to: Yessenia Torruellas
____ Online-Easy Enroll Credit Card payment
____ PAID
*PAYMENT MUST BE MADE IN FULL PRIOR TO FIRST DAY OF CLASS. WE CAN'T RESERVE A SPACE UNTIL PAID IN FULL.
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How did you hear about us
_________________________________________
Please initial each item and sign and date at the bottom
____ I understand and agree that if I must cancel my registration, I have to do it written prior to this date: ____________________ to get 50% of the total refunded. 50% is non-refundable.
____ I understand and agree that if my child misses
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