| LANGUAGE ANYWHERE, Inc. |
| Name : ____________________________________ Date of Birth: M____ / D_____ / Y______ Address: __________________________________ ___________________________________________ Phone: ____________________________________ E-mail:_____________________________________ Will you be present during the class? It is very important for the psychology of the child to know that at any time during the class he/she can rely on a relative or nanny. o Yes o No. Name : ____________________________ Has your child ever studied French before? For how long? Where? ______________________________________________ ______________________________________________ ______________________________________________ What do you expect from the class? ______________________________________________ ______________________________________________ Does he or she have allergies, or any kind of health problem of which our instructor should be aware? ___________________________________________ ___________________________________________ How did you hear about us? ___________________________________________ Policy: Your registration will be processed once we receive your payment, which is due before the beginning of your program. Please make sure to contact your instructor at least 24 hours in advanced if you cannot attend a class, any cancellations made within 24 hours will be charged. |
| REGISTRATION FORM FOR KIDS |
| Contact our programm coordinator at French classes@languageanywhere.com prior to sending your registration form since classes may already be filled. |