Register for Children’s Spanish Classes

Children's classes - Escuela Bolivia Program - Spring Semester 2013 - Children Registration Form
Registrant's First Name
Last Name
Address
City, State, and Country
Zip Code
Registrant's email
Student's First Name
Last Name
Sex
Female Male
Date of birth
Age
Place of birth
Ethnicity
Language spoke at home
Grade in 2012-2013
Name of school
Mother's name (or legal guardian)
Mother's occupation
Mother's phone number
Father's name (or legal guardian)
Father's occupation
Father's phone number
Level of Spanish comprehension
Previous studies in Spanish?
If so, where?
Does the student have an Individualized Education Program (IEP)?
Emergency contact (other than parent)
Relation to student
Emergency phone number
How did you hear about us?
Registration fee - Please type 0 if you are applying for a need-based or family-based discount. If you are applying for a discount, you must pay-at-the-door.
Amount
Payment Type
Please make checks payable to Edu-Futuro and mail to 2801 Clarendon Blvd. Suite 216, Arlington, VA 22201.
You may pay online via our website's PayPal button found at the bottom of this page. Simply click on the button to proceed.
Additional comments
If you are registering for Project Family, please type Project Family in the "Additional Comments" box!