2004 Summer Program Session IV (August 2 –August 13)

Enrollment Form

 

学生姓名(英文)                                                      (中文)  

Student Name (English):                                               (Chinese):                                      

年龄                                性别                             生日      

Age:                                   Gender:                                   Date of Birth:                         

家庭住址

Home address:                                                                                                                   

家长或监护人

Parents/Guardians:                                                                                                              

电子邮件

E-mail:                                                                                                                               

电话(住宅)                                                         (工作)

Phone (home):                                                       (work):                                                   

                                                                (手机)

                                                                             (cell):                                                      

 

1.      Morning (9 am — 12 pm) $160.00                                                                         

2.      All Day (9 am — 3 pm) $275.00                                                                            

3.      Extended (8 am — 6 pm) $315.00                                                                         

4.      Lunch (□M□T□W□T□F) $2.60/day                                                               

5.      Registration fee (for new students only) ($20.00)                                                    

 

                                                                                                 Total:                           

 

SCA offers a 10% discount on tuition for each additional child from the same family.

 

Please write your check payable to Sammamish Chinese Academy and send your check to 4228 257^th PL SE, Issaquah, WA 98029 by July 19, 2004.

 

Please add 15% late registration fee to your total if you register after July 19, 2004. 

 

There will be a $30.00 cancellation fee.