____________________________________________________________
Student Name
____________________________________________________________
Age & Birthdate Male/Female Grade (Fall 2007)
____________________________________________________________
Parent/Guardian Name
____________________________________________________________
Address
____________________________________________________________
City State Zip
____________________________________________________________
Phone (Daytime) (Evening)
____________________________________________________________
Email address
ClassID# Class Name
Class 1: ________ _________________________________________
Class 2: ________ _________________________________________
Class 3: ________ _________________________________________
Class 4: ________ _________________________________________
Registration Fee (new student for 2007-2008): $15.00
Payment preference (check one):
per Month Semester Annual
_______________________________________ _________________
Signature Date
Instructions
Please print this page and fill-out all information, one registration per
student. Choose the payment option you prefer: per month, semester, or annual.
When finished, please mail the form plus payment to the address below.