Registration

Educando a América

REGISTRATION FORM-SCHOOL YEAR 2010-2011

DATE:

STUDENT´S NAME:

COUNTRY OF BIRTH:

BIRTH DATE:                                                    AGE:                                       GRADE ENTERING IN FALL 2010:

ADDRESS:

FATHER´S NAME:
COUNTRY OF BIRTH:

ADDRESS :

HOME PHONE:
WORK PHONE:

MOTHER´S NAME:
COUNTRY OF BIRTH:

ADDRESS:

HOME PHONE:
WORK PHONE:

E-MAIL:

PARENTS´ FIRST LANGUAGE:

LANGUAGE SPOKEN AT HOME:

OTHER LANGUAGES:

NOTIFY IN CASE OF ILLNESS OR ACCIDENT:

NAME:
PHONE:

AUTHORIZED PERSONS TO PICK UP CHILD FROM SCHOOL:

NAME:
PHONE:

ADDRESS:
RELATIONSHIP:

NAME:
ADDRESS:

PHONE:
RELATIONSHIP:

I PREFER TO RECEIVE SCHOOL COMMUNICATIONS IN:            SPANISH            ENGLISH                   BOTH

HOW DID YOU KOWN ABOUT  THE SCHOOL?:

SIGNATURE:                     PRINT:

Complete this registration form and send it to Educando a America/ 1562 NW 168 Av./Pembroke Pines/Fl/33028

Comment (RSS)  | 

7 Comments

  1. Jeannie Schoenfeld:

    I currently have our daughter taking Spanish class once a week. I would like to see what your school offers and if it is equivalent to where I have her or better in order for her to attend your program. I am interested in having her start as soon as possible.

    Jeannie Schoenfeld

    You can contact me via email.

    Thank You

    ,

  2. admin:

    Thanks for contacting us. We will contact you via email.

    EA staff.

    ,

  3. Teresa Van der endt:

    Ref: Sebastian Bertaina

    Por favor quiero cargar el pago a una tarjeta de credito. Para mi es mejor hacerlo asi.Como lo podemos hacer. Aqui no aparece como ponerlo.

    Teresa van der endt
    954-600-5056

    ,

  4. Grace Morejon:

    Hello. I am interested in registering my daughter for the Spanish summer camp Tuesday and Thursday 4pm to 7pm.

    I tried to find the registration and payment form on your website; but I was not successful. Can you please send me the information I need and or registration form–what day does this camp begin? She is 10 years old going into 6th grade and she is a beginner.

    Please feel free to email/send me everything I need to get her started. Thank You! Grace

    ,

  5. Lyclastyclems:

    thanks! :)

    lets write them until the admit it, or stop doing it! i am writing them now!

    :)

    ,

  6. E Schmidt:

    I am interested in information on Jugarte for my 4 and 7 year olds. When is it offered and what is the cost? Thank you.

    ,

  7. Golf Balls:

    In related news, Tiger Woods stars in a movie called “My Favorite 18 Holes.” It turns out it’s actually about golf.

    ,

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