2019-20 SHAFFER SPANISH Registration Form
PLEASE PROVIDE ONE FORM FOR EACH CHILD REGISTERED
Student Name and Grade in School (2019-20)
Any special allergies or needs?
Previous Background in Spanish?
SPANISH CLASS SELECTION: Please indicate preferred class below. (Notes: All classes are held M/W from 8:05 - 8:50 a.m. For students in K-4, those advanced in Spanish may be placed one level above their regular grade.)
PARENT CONTACT INFORMATION
Please include first and last names of both parents as well as an emergency contact person.
Mother's Cell Number
Father's Cell Number
OTHER EMERGENCY CONTACT (Name & Cell #)
40 Classes, M/W Schedule (8:05 - 8:50 a.m.)
Annual Tuition $560.00 + $15 Registration Fee
$575.00 = TOTAL COST (Please note: For Siblings registered in program, deduct $20 each for Family Discount.)
NEW! SPLIT PAYMENT OPTION - Pay half of Total Cost at time of registration; Balance is due by November 15, 2019.
Write your calculated tuition amount here for ONE Spanish Student:
PLEASE COMPLETE the REGISTRATION PROCESS with TUITION PAYMENT AND PARENT SIGNATURE
To pay online, go to
and click on SHAFFER ELEMENTARY. We accept all major credit cards.
Checks should be written to Language Logix and mailed to LANGUAGE LOGIX, P.O. BOX 270204, LITTLETON, CO 80127.
CANCELLATION POLICY & PROCEDURES
A full refund will be given for cancellations made BEFORE classes begin.
A prorated refund (minus $50 processing fee) will be given after classes begin but before 10/27/19.
No refunds will be given for cancellations made AFTER the date of October 27, 2019.
I HAVE READ AND I AGREE TO THE CANCELLATION POLICY & PROCEDURES LISTED ABOVE.
Electronic Signature (Parent/Guardian)
Thank you! We appreciate your support for Spanish enrichment at Shaffer Elementary. Carol Edwards, Program Director
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