Forms and payments may be dropped off at any time during our office hours. Register in person, by mail, fax 212 697-8379 or phone at 212 697-8374. There is a $30 registration fee per student.
Payments may be made with
MasterCard, Visa, JCB
Cash (at Registration Office only)
Money order or check (made payable to Amity Language institute).
There is a $30 fee for each returned check.
(*required)
*Name
(last)
(first)
Date of Birth
/
/
(mm/dd/yy)
*Address
Street
Apt. #
City
State
Zip Code
*Primary Phone
Cell Phone
Fax
E-mail
Company
*How did you hear about us?
Please select a desired course
Courses for Adults
Basic User A1
[FA101]
[FA102]
[FA103]
Starting date:
/
/
(mm/dd/yy)
Basic User A2
[FA201]
[FA202]
[FA203]
Starting date:
/
/
(mm/dd/yy)
Independent User B1
[FB101]
[FB102]
[FB103]
[FB104]
[FB105]
Starting date:
/
/
(mm/dd/yy)
Independent User B2
[FB201]
[FB202]
[FB203]
[FB204]
[FB205]
[FB206]
Starting date:
/
/
(mm/dd/yy)
Private lessons
At Amity Language Institute
Off-site
{Desired location:
Home
Office
Other
Address:
Number of hours:
Student’s level:
Learning history:
Goals:
Semi-private lessons
At Amity Language Institute
Off-site
{Desired location:
Home
Office
Other
Address:
Number of hours:
Number of students:
Student’s level:
Learning history:
Goals:
Courses for Children
Classes for Children 7 to 10 years old
Grenadine A1.1
Grenadine A1.2
Starting date:
/
/
(mm/dd/yy)
Classes for Children 11 to 14 years old
Et toi ? A1.1
Et toi ? A1.2
Et toi ? A1.3
Starting date:
/
/
(mm/dd/yy)
Classes for Children 15 to 17 years old
French Grammar Review
Starting date:
/
/
(mm/dd/yy)
Private lessons/Tutoring
At Amity Language Institute
Off-site
{Desired location:
Home
Office
Other
Address:
Number of hours:
Student’s grade:
Name of school:
Student’s level:
Learning history:
Goals:
Method of Payment
Check or Money Order (made payable to Amity Language Institute).
Credit Card:
MasterCard
Visa
JCB
Cash (at Registration Office only)
© 2007 Amity Language Institute. All rights reserved.
