ENROLLMENT FORM
Email address *
Class *
Child Information
First Name *
Your answer
Middle Name *
Your answer
Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Race *
Your answer
Language(s) spoken at home *
Your answer
Parent / Guardian informations
First Name *
Your answer
Last Name *
Your answer
Child's relationship *
Your answer
Address *
Your answer
City *
Your answer
Day Phone *
Your answer
We do not have scholarships available at the moment. Would you like to be informed when it becomes available? *
Please briefly state why you would like your child to attend this program. *
Your answer
How did you hear about us *
Your answer
What is the best way to contact you upon receiving your enrollment application to meet with you and the applicant *
A copy of your responses will be emailed to the address you provided.
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