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Student information
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Child #1 Name
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Last
Child #1 DOB
*
Child #1 Sex
*
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Child #2 Name (if applicable)
*
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Child #2 DOB (if applicable)
*
Child #2 Sex (if applicable)
*
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If more than two children, please write first name, age and sex here
*
Nationality
*
What language do you speak at home?
*
Level of French
*
School name
*
School year
*
Parent information
Parent Name
*
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Last
Address
*
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Email
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*
Emergency contact
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Emergency Contact Phone Number
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Medical condition we should know:
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Permission to use photography
*
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Under some conditions
When you click yes you allow us to use photography for publicity purposes: website, facebook page, press.
If Under some conditions, please precise.
*
Please tick
*
I understand that I have to pay $55 of annual administration fee per family.
I understand that I have to pay fees before class.
Date
*
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If you have been referred please put the name of the person who is referring you :
*
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Home
Testimonials
Adults
Become a French Actor
Performances
Pinocchio
Past Performances
Children
French Holiday Program
>
French Background
French Learner
Contact
About us
