Enrollment Form

First Name

Last Name

Parent's First Name

Parent's Last Name

Street Address

City

State

Zip Code

Student's E-mail

Telephone # (area code)

Parent's E-mail
(If applicable)

Alternate telephone #

Grade Level

Have you taken
Spanish before?
(yes or no)

If yes, for how long?

How did you hear about us?

Comments:

*How many siblings are under 18 yrs?

Student's Birthdate

Are you taking this course for credit?

Has an immediate family member previously
taken this course?

Which course are you Enrolling for?

Where did you take Spanish I?

If other, please tell us where.

Do you need an assessment test to take Spanish II with Dígame en español?

If so, who?

Which Class Day are you enrolling for?

Continue to the Transaction Page

Name & Address of Umbrella School

*A $50 discount will be given to those having more than one student enroll in the program.