Clases de inglés Enrollment Form
Name
What is your birthday?
What is your native language?
What is your home country?
Phone
Email
Which option best describes your English skills?
Beginner
Intermediate
Advanced
Describe your goals for this class below:
Emergency Contact Name
Emergency Contact Phone
Special Needs / Accommodations
Will you be enrolling your child / children into the Kid's S.T.E.A.M. Club?
Yes
No
How many children will you be enrolling in the club?
Do you give permission for your child/children to participate in S.T.E.A.M. Club activities?
Yes
No
Do you give permission for instructors to use photos/videos of your child / children during Club Activities for Empowerment Tutoring LLC's Google Business Profile, Website, and marketing materials?
Yes
No
Submit