2017-18 School Year

Family Information

Mother's Name (ENG)

МАТЬ: Имя / Фамилия (RUS)

МАТЬ: Отечество (RUS)

Father's Name (ENG)

ОТЕЦ: Имя / Фамилия (RUS)

ОТЕЦ: Отечество (RUS)

Address

Home Phone (optional)

Mother's Cell Phone

Father's Cell Phone

Please list the PRIMARY EMAIL by which you wish to receive school information (school announcements, school closings due to inclement weather, etc.).

This should be an email that you check regularly, as important school information is sent weekly.

Primary Email

Additional Email (Optional)

Please list an emergency contact phone number to be used while school is in session (i.e. Saturday mornings):

EMERGENCY Phone Number

Student Information

1st Child: Name (ENG)

1-й Студент: Имя (RUS)

1st Child: Gender

Male
Female

1st Child: Date of Birth

1st Child: Grade Level

Does your child have any medical issues that the school administration needs to know about?

1st Child: MEDICAL ISSUES:

If YES, please explain:

CHRISTMAS PLAY / РОЖДЕСТВЕНСКАЯ ЁЛКА

Will your child be participating in the Christmas Play?

Ваш ребенок будет принимать участие в спектакле?

(MANDATORY Dress Rehearsal: Saturday, January 13, 10am-2pm. Christmas Play: Sunday, January 14, 3pm.) (Обязательная Генеральная Репетиция: 13 января (суб) в 10 часов. Рождественская Ёлка: 14 января (воск) в 3 часа.)

1st Child: Yolka Play Participation

2nd Child: Name (ENG)

3rd Child: Name (ENG)

4th Child: Name (ENG)

Payment Options

FULL Payment - 1 student ($430.00)
(price includes $50 discount for paying in full)
FULL Payment - 2 or more students ($680.00)
(price includes $70 discount for paying in full)
PARTIAL Payment Plan - 1 student ($480.00)
Initial deposit of $240. Your credit card info will be stored securely, and an additional payment of $240 will be posted on December 18.
PARTIAL Payment Plan - 2 or more students ($750.00)
Initial deposit of $375. Your credit card info will be stored securely, and an additional payment of $375 will be posted on December 18.

Running Total

$0.00

Coupon Code

Total

$0.00

Billing Information

Name on Card

Credit Card

Visa
Mastercard
American Express
Discover

Billing Address

Phone Number

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