TUITION Info: Preschool :: After School :: Summer School :: Enrichment Classes

Registration Form: August 28, 2007 - June 13, 2008

Student's Full Name:

Grade next year:

Home Address:

City:

Zip Code:

Home Ph:

( ) (no dashes or space, 7 digits)

School:

Birth Date:

Parent/Guardian's
Name:

Email:

Work Phone:

( ) (no dashes or space, 7 digits)

Cell Phone:

( ) (no dashes or space, 7 digits)

I would like to register my child for the following program(s):

Preschool:

Full day AM PMPart dayLunch

After School:

3 days/week 4 days/week 5 days/week

School Break:

Full day	Half day	Lunch
Early Care	Extended Care
Dates: (range: mm/dd/yy - mm/dd/yy)

Enrichment Classes - offered year-round:

Piano:

Judo:

Chinese Culture & Language:

ShaoLin KungFu Zen:

AmericaEd is a California Public Benefit Corporation under section 501(c)(3)
of the Internal Revenue Code, and we accept students from 4C's, CalWorks, PACEAPP, Choices for Children, and Santa Clara County CDP programs.

Last updated 05/29/2008