ICS Registration Form

Language & Cultural Play

for Children and Adults

Last updated: 07/22/2008

A department of

Atkins International Associates, Inc.

65 Old Highway 22,

Suite 2

Clinton, NJ 08809

(908) 735-9911

ICS FOREIGN LANGUAGE ENRICHMENT PROGRAM

WorldPlay reserves the right to cancel classes or change the schedule due to enrollment.

Class start date to be determined.

ALL WORLDFRIENDS CLASSES ARE $170.00 PER SESSION.

THIS PRICE INCLUDES ALL MATERIALS, REGISTRATION AND CLASSES. DVDs ARE AVAILABLE FOR AN ADDITIONAL COST.

If you are interested in a class not listed, send us an email and tell us what you are looking for - we may be able to form other classes.

Registration for Winter and Spring is now open. Winter semester starts the week of January 7 and Spring starts the week of March 31. If you register for both semesters now, you will receive $10.00 off.

WINTER 2008 ICS REGISTRATION FORM Class may be cancelled or combined due to low enrollment.

JAPANESE	not offered at ICS - only in Clinton
CHINESE
SPANISH	not offered at ICS - only in Clinton
ITALIAN
GERMAN	not offered at ICS - only in Clinton
FRENCH	not offered at ICS - only in Clinton
ARABIC	not offered at ICS - only in Clinton

Name of Child:

Date of Birth:

Parent Name:

Address:

City: Zip:

Email:

Phone number:

CELLPHONE NUMBERS FOR BOTH PARENTS:

FOOD ALLERGIES:

Please list any other languages your child speaks or has been exposed to (by grandparents for example - or trips to a country that speaks the language) - please also tell us if they have studied this language before.

Anything we should know about your child - how they learn, are they shy, any disabilities?

No schedule posted for a language in which you are interested? Please tell us what you want to see:

Please submit this form. A confirmation page will appear. Print it out and mail it with your check payable to: Atkins International. 65 Old Highway 22, Suite 2, Clinton, NJ 08809 - If you prefer to pay with a credit card, click this box and we will email you an invoice that you can pay securely online.

I WANT TO PAY WITH A CREDIT CARD! (if you mark this, we will send you an email with a secure link to pay online)

$170.00 per child (tuition, materials, t-shirt, registration)

$20.00 for class DVD (optional) - please check here if you want a DVD

Total Amount to Be Paid:

When we receive your payment, we will send you a receipt and confirm the start date of the program. We reserve the right to cancel a program due to low enrollment. Missed classes cannot be made up.

DON'T SEE WHAT YOU ARE LOOKING FOR? Send us an email.

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Children who learn a second language typically have better problem solving abilities, better reasoning skills, and are more creative.

Constructive play in an immersion setting.

Children who have learned a foreign language have higher levels of self-confidence.