EmailMe Form - Children registration form

Student name

First Last

Birth date

Age

Indicate which school your child is going

Grade

Parent's name

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Parent's e-mail

Home phone

### - ### - ####

Cell phone

### - ### - ####

Alternate contact when you're not available.

Phone alternate contact

### - ### - ####

Child allergies

Has your child studied french before?

Yes

No

How many years?

Where?

Please select your program.

Group classes

Individual classes

Semi-group classes (2 to 3 children)

Please select your class

When would you like your child to start french classes?

Private class only

How did you learn about us?

Internet

Friends

Relatives

Commercial

Payment
The payment for all courses in our location has to be done before the first day of the course (no HST is applied to tuition fees).

Method of payment
Payments can be made by cash or cheque payable to École Napoléon at our location. *

I agree

Signature of parent / guardian (Initials)

Date

MM / DD / YYYY