Request edit access
Mariposa Bilingual School Registration Form
Step 1: Fill out completely and submit the registration form below. If not applicable, please write "N/A".

Step 2: Please send a $75 non-refundable registration fee and $300 deposit towards tuition to secure your child"s placement to at Mariposa Bilingual School. Please mail the check with your child's name on the memo line.
Please mail the check to:

Mariposa Bilingual School
P.O. Box 150886
San Rafael, CA 94915-0886



Your application will be processed once we have received both your registration form and non-refundable registration fee.

Tuition is based upon sessions during the school year. Each session is 3 months. Tuition must be paid 30 days in advance prior to the start of the session. Tuition payment plan options:

Option 1: Pay in full 30 days advance prior to the session
Option 2: Pay in two installments:
First installment: 30 days in advance prior to the start of the session
Second installment: Due on the 1st day of the 2nd month of the session.

Please know that it is your responsibility to keep track of when payment is due. Failure to pay by due date will result in a late fee.
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Home Address *
Your answer
Home Phone *
Your answer
Language(s) Spoken by Child *
Your answer
How did you hear about our school?
Your answer
First Parent's Full Name *
Your answer
Home Address *
Your answer
Home Phone *
Your answer
Occupation
Your answer
Name of Company
Your answer
Address *
Your answer
Work Phone *
Your answer
Cell Phone *
Your answer
Email Address *
Your answer
Second Parent's Full Name
Your answer
Home Address
Your answer
Home Phone
Your answer
Occupation
Your answer
Name of Company
Your answer
Address
Your answer
Work Phone
Your answer
Cell Phone
Your answer
Email Address
Your answer
Monday
Tuesday
Wednesday
Thursday
Friday
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy