Date: 20-05-2012
Parents Name:
Emails:
Children’s names/ages:
Phone Home:
Phone Mob:
Street Address:
Area and zip code:
Desired Time of day:
Desired Days of the Week:
Length of lesson (approx):
Reason/Goal for lessons:
Start date desired:
If moving abroad, to where and when?:
Rut Avdrag Eligible?:
Do you live 30 min outside of the city by public transportation? (100:- Travel fees applies ( 50:- after RUT)):
Teacher, male or female, preference if any?:
British or American accent, preference if any?:
Other Info:
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Register now for Summer Camp, week 25 or 26 or both weeks!
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