Step 1: Family Information / Please enter your contact information. School info and newsletter are sent to both emails.
First Name / Last Name
Address
City / State / ZIP
1stEmail / 2nd Email (optional)
Heritage (optional): Germany Austria Switzerland
Step 2: Emergency Phone Numbers
Cell Phone (Mother) / Cell Phone (Father)
Home Phone / Other emergency contact
Step 3: Student Information
First and Last Name / Date of Birth / Place of Birth1 / Grade / Allergies (Drugs, other) / Photo Permission2
1 / yes no
2 / yes no
3 / yes no
4 / yes no
1 Required information for A1, A2, DSD testing 2 Permission for EGLS to use photographs or interviews in all publications internal and external
Step 4: RegistrationFee & Donations / Please choose registration option.$ 0
$ 50
or .. $ 100 / Early Registration(register beforeJuly 31, 2017withfull tuition payment)
Regular Registration for Playgroup and Halftime Classes
RegularFamily Registration
fees non-refundable and due at time of registration / $
Amount
Tax-deductible donation to EGLS / $
Amount
Step 5: Tuition Fees / Please add up tuition fees for all students.A teacher discount may apply. 2
# of Child Students / $775
+ $675
+ ____ x $575 / 1stChildStudent
2ndChildStudent3
AdditionalChild Student(s) (each) / $
Amount
# of Playgroup/AP/Adult Students / + ____ x $425 / Playgroup/Halftime Classes / $
Amount
3Teacher discount option. / $
Total
Step 6: How did you learn about EGLS?
Step 7: Signature & Schedule Sign and choose a payment option. First payment is always due on the 1st day of classes.
Parent/Adult Signature4, 5 / 1 full paymentdue on 1st day of classes(Early registration only availableuntil July 31, 2016)
2 equal paymentsbilled in Sep 2017 andJan 2018
9PayPal subscriptioninstallments startingin Aug 2017- only for returning families / ______Installments
Of $ ______each
4 I agree to the EGLS cancellation policy and 5I hereby give permission that my child(ren) may be given emergency treatment by a staff member at the Eastside German Language School. I also give my permission for my child to be transported by ambulance or aid car to an emergency center for treatment.
In the event that I cannot be contacted, I further consent to medical, surgical, and hospital care, treatment, and procedures to be performed for my child by a licensed physician or hospital when deemed immediately necessary or advisable by the physician to safeguard my child’s health.
Non-Discrimination Statement: The Eastside German Language School admits students of any race, color, creed, national and ethnic origin, and sexual orientation to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, creed, national or ethnic origin or sexual orientation in the administration of its educational policies, admission policies, financial aid programs, athletic programs, hiring and employment, or in any other way.
Please make checks payable to “EGLS” · PayPal subscription available on the website; credit card required.Eastside German Language School, 12819 SE 38th St #496, Bellevue, WA 98006 ·