The “Little Ambassadors”

Winter Registration 2007- Six weeks Semester (Pilot Program)

Location: Wilkins School Community Center

7604 Charleston Avenue

Swissvale, PA. 15218-1265

The winter Semester will run from Tuesday, January 9^th for 6 consecutive weeks.

My child would like to attend on: (Please designate your first choice)

*Schedule subject to change based on enrollment.

__ Ages 5-8 Tuesday and Thursday 4:00-4:30

__ Ages 9-10 Tuesday and Thursday 4:30-5:15

__ Ages 9-10 Tuesday and Thursday 6:00-6:45

__ Ages 5-8 Tuesday and Thursday 6:45-7:15

__ Ages 9-10 Tuesday and Thursday 7:15-8:00

__ Ages 2-3 By request

Yes, sign my child up!

Please enroll my child/children in your six week beginner’s Spanish Language Program taught by native, experienced instructors.  I understand that my child may attend classes twice a week and that the six weeks program fee of $90.00 includes all Materials, Registration and class Graduation.

Child’s information:

Name:_______________________________________ Nickname:_______________

Age:______ DOB _____/_____/______ Gender: ___Female ___Male

Guardian information:

Name:________________________________________Relationship to child:____________

Mailing Address:_______________________________________________________

City:____________________________State:_______________Zip:______________

Home Phone: ( )___________________Cell Phone: ( )__________________________

Work Phone: ( )_______________ Email Address:________________________________

I am aware that the center will provide experienced instructors and supervision and that the Wilkins School Community Center shall not be held responsible for any mishap or accidents.

Return Registration via Email, Mail or Fax by Friday, January 5^th 2007.

Payment (check or visa/Master Card due first day of class)

Languages by Nicole, Inc.

Languagesbynicole.pgh@verizon.net