2025-2026 Bee Bilingual Learning Center Registration Form
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Email *
Student Name  (First Name, Last Name) *
Student Preferred/Russian name 
*
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Age
 *
Name of School/ Grade / Town
Class selection (print the name of the class, day and time).  

For new students: Please select the class you would like to attend. We will contact you and ask questions to ensure that the class you choose is right for your level.  *
First and Last Name of Parent/Prim. contact: *
Cell Phone *
Email address *
Facebook Contact
First and Last Name of Parent/Sec. contact: *
Cell Phone *
EMERGENCY CONTACTS (please provide 2 additional people, different from the parent/guardian listed above, who would automatically be the first person we contact)

Full Name and cell phone
 *
Student's Mailing Address (City, State, Zip Code)
The best way to contact you?
Clear selection
SAFETY INFORMATION (please list all known conditions so we can accommodate your child's need)

Does your child have any medical condition, allergies, or special needs the staff should know about?
 *
Does your child have any behavior issues? 
*
Other information you think we should know
Family Language/ Child's First Language *
Can your child read and write in Russian?
*
Select a payment method.

 Reminder: You must pay the full monthly tuition in advance within the first few days of the month. 

A $25 late fee will apply if not paid by the 5th of the current month.
 *
If you chose Zelle, please provide the phone number or email that is linked to your Zelle account. We will send you a payment request at the beginning of each month.
Are you our current student?
Clear selection
How did you know about us? *
Submit
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