EmailMe Form - CWS Parent-Child Program, Fall Session 2014

CWS Parent-Child Program, Fall Session 2014

Please complete and submit this form with the class fee by September 8, 2014 in order to secure a place in the class.

The cost of each 6-week session is $130. You may mail a check for the class fee to our Enrollment Director:

Charlottesville Waldorf School
120 Waldorf School Road
Charlottesville, VA 22901
ATTN: Enrollment Director

You will receive confirmation of registration by email once payment is received.

Make-up classes - Due to limited enrollment, missed classes cannot be made up on different days.

Fall Session 2014 *
Mondays, 9:30-11:30, 6 classes (Sept 22 - Oct 27)
Fridays, 9:30-11:30, 6 classes (Sept 26 - Oct 31)
Mondays, 9:30-11:30, 6 classes (Nov 3 - Dec 15; no class 12/1)
Fridays, 9:30-11:30, 6 classes (Nov 7 - Dec 19; no class 11/28)
Child's Full Name *
First Last
Child's Nickname
Birth date *
MM / DD / YYYY
Gender *
Male
Female
Medical Issues or Allergies *
Parent/Guardian Name #1 *
First Last
Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region
Email *
Phone *
### - ### - ####
Parent/Guardian Name #2
First Last
Address

Street Address City State / Province / Region Postal / Zip Code Country / Region
Email
Phone
### - ### - ####
How did you learn about our classes? *
CWS Parent
CWS Website
Friend
Charlottesville Family
AWSNA
Search engine
Facebook
Flyer/Poster
Other (please specify)

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