Select a language (a) Spanish (b) ESL (c) Accent reduction
Select Children/teen program ( ) adult program ( )
Mobile number ________________________
Payment by credit card # ___________________________________________
Expiration date ___________
Signature to accept charge __________________________
Program selected ( ) a ( ) b ( ) c ( )
Classes meets for 45 minutes/1x week/ for 5 weeks. Program cost $261* for a private full immersion class.
Visa ( ) Mastercard ( ) American Express ( ) discover ( ) bank check ( ) cash ( )
NO PERSONAL CHECK ACCEPTED
58 Bergen St, Westwood, N.J.,07675 201 263-1443
firstname.lastname@example.org or email us the form
*Material is included. Should you withdraw, only a credit good for life of program is granted.
No make up classes is given if you miss a class. Only if the center is closed due to inclement weather we will offer a make up class.
Date program starts ________________ends ________________
+Call center for prices on our tutoring, Bilingual Child and other Spanish and ESL Programs.