Immanuel German School Registration Form 2010/2011

 

Student Information

First Name

Last Name

Age

Sept 2010 school grade

Previously attended German School?  If yes, give name of last yearŐs teacher.

Knowledge of German: none, little, moderate, good, excellent

1.

 

 

 

 

 

2.

 

 

 

 

 

3.

 

 

 

 

 

4.

 

 

 

 

 

 

Medical conditions/allergies/medication (use back if necessary)

 

Language spoken at home

1.

 

2.

 

3.

 

4.

 

 

Tuition for both semesters (30 Saturdays)

 

Child 1:

$415.00

Child 2: $320.00

Child 3: $260.00

Child 4: Free

Amount Due:

Payment:

Date:

Check  Cash

 

Balance Due:

 

The familyŐs registration fee of $35 is included in the first childŐs tuition.  This fee will be waived if payment is made in full by September 1.  Tuition does not include the cost of books.  The book charge will be communicated on the first day of class. Please make checks payable to the Immanuel German School, and mail to: Karin L. Hazzard, Treasurer, 45 Farmway Drive, Richboro, PA 18954.

 

Parent Information                                                                 Emergency Contact Information

Parents

 

Name

Home Phone

 

Work Phone

Cell Phone

Relation

Home Address

 

Home Phone

Cell Phone

City

State

Zip

I hereby authorize any of the teachers and/or German School administrators to give consent for medical treatment to be administered to my child(ren) in case of a medical emergency.

Email

 

 

 

Signature

Date

 

I would like to volunteer with                            

___ Christmas Program                        ___ Classroom Assistance                      How did you hear about our program?                                                    

___ yes  ___ no  I grant the Immanuel German School the right and permission to use and publish photographs/film/videotapes/electronic representation and/or sound recordings have made of my children for educational and/or publicity purposes only, including the website and I hereby release the Immanuel German School from any and all liability from such use and publication.

___ Please check this space if you would like to receive a text message via cell phone in the event of a school closing.

___ Do not include my address and telephone number in the schoolŐs student directory, which will be given to our families only.         

 

Website: www.theimmanuelgermanschool.org

Email: Principal@theimmanuelgermanschool.org

Phone: 215-676-1170