Registration Form

We offer an authentic year round Spanish after school program on Mondays at PS 183. We provide a safe and encouraging atmosphere to learn Spanish from experienced native teachers for Pre- K to 5th.

Session one runs from September to January
Session two runs from January to June.

• The price $ 730.00 for one semester and $ 1, 440 for two semesters.
• The space is limited and a minimum of 6 (six) children are required to hold the class. The price includes materials and refreshments.
• Withdrawals and refunds: If a parent withdraws a student from this program within the first two classes (two weeks), any tuition will be returned to the parents, minus a $60.00 charge to cover the cost incurred for those weeks. There will be no refunds, for any reason after the second week. Children must be picked up at the according time, depending on the class that you registered for. Any check rejected will be charged a $35.00 fee.
• Please complete the entire form and return it with your payment to “Iberian-American Language Institute” c/o Maria Ruscelli. 68-12 Yellowstone Blvd. Apt 4P- Forest Hills, NY 11375 Tel: (212) 688 6619 / Cell: (917) 805-1232

Child's Name:

Age:

Grade:

Date of Birth:

Does your child have any allergies?

Yes No

If so, please state them

add another child's data?

Parent or Guardian´s Name:

Authorized person to pick up the child:

Address:

Apt #:

City:

Zip Code:

Email:

Telephone:

Cell:

What language does he/she speak at home?

If so, please state

Parent consent: I have read, understood, and agreed to the Iberian American Language Institute’s class’s withdrawal and tuition policies. I understand that the Iberian American Language Institute reserves the rights to limit, deny or terminate enrollment and participation in order to maintain a safe program.

 

Permission is given to photograph:

Yes No

Register for:

1 Session Full Year

 

 

 

Submit

 

Pay with check

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