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Registration Form

This document is a registration form for POCOLOCO Spanish Programs, located in Albuquerque, New Mexico. It requests information such as the child's name, age, grade, school, home address, phone numbers, and emergency contact. The parent must initial lines acknowledging their understanding of policies regarding after-class supervision, monthly tuition payments, no reimbursements for missed classes or early withdrawals, required notice for withdrawal, grounds for removal from class, and encouraging practice of the language at home. The form concludes with spaces for the parent's signature and date.

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Carissa Nichols
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240 views2 pages

Registration Form

This document is a registration form for POCOLOCO Spanish Programs, located in Albuquerque, New Mexico. It requests information such as the child's name, age, grade, school, home address, phone numbers, and emergency contact. The parent must initial lines acknowledging their understanding of policies regarding after-class supervision, monthly tuition payments, no reimbursements for missed classes or early withdrawals, required notice for withdrawal, grounds for removal from class, and encouraging practice of the language at home. The form concludes with spaces for the parent's signature and date.

Uploaded by

Carissa Nichols
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Maria Nilsson-Whitaker, dba POCOLOCO Spanish Programs

9600 Peralta Rd NE
Albuquerque, NM 87109

Teléfono: (505) 797-8980


Correo Electrónico: [email protected]
Pagina Web: www.pocolocospanish.com

Documento de Matriculación/Registration Form

Favor de completar, firmar y mandar a Maria en la dirección de arriba/Please complete,


sign and send to Maria at the address listed above

Nombre de niño(a)/Child’s Name: ___________________________________________

Edad/Age: ______ Grado Escolar/Grade: ______ Escuela/School: ______________

Fecha de Nacimiento/Date of Birth: ______________________

Dirección de Hogar/Home Address: _________________________________________

Código Postal/Zip Code: _________________

Teléfono a Casa/Home Phone: ______________; Celular/Cell Phone: _______________

Correo Electrónico/E-mail: _______________________________________________

Contacto de Emergencia/Emergency Contact: _________________________________

Teléfono de Contacto de Emergencia/Emergency Contact Phone: __________________

Favor de marcar con sus iniciales/Please Initial:


____ I understand that neither POCOLOCO Spanish Programs nor the staff at the class-
hosting facility can be responsible for my child after 3:00 pm when Spanish class is over.
____ I understand that the monthly tuition is due at the beginning of each month and
should be sent directly to POCOLOCO’s postal mailing address. I will not send payments
directly to the teacher via my child. (OVER )
____ I understand that POCOLOCO does not reimburse tuition payments for missed
classes or early withdrawals.
____ I will inform the teacher about possible or pending withdrawal the month prior to
such so that my child’s Spanish class space can be offered to a student on POCOLOCO’s
waiting list.
____ I understand that POCOLOCO reserves the right to request the withdrawal of any
student whose conduct is disruptive to other members of the class after due warning and
the opportunity to rectify the problem have been given.
____ I will encourage my child to practice the language lessons as best I can.
____ I understand that foreign language acquisition takes time and I will do my best to
keep my child in the program for the whole academic year.

Firma de Padre o Madre/Parent’s Signature:

Fecha/Date:

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