Tustin Memorial Academy – Foreign Language Club Enrollment Form
Please complete one form per student per class enrolled
Return completed form with payment in the school office (Foreign Language Folder) by Sept. 18th.
Classes start the week of September 28th
Classes Offered (All schedules tentative, classes are held on TMA campus, rooms TBD)
Circle class as applicable:
Monday
8:50– 9:35 am
LATE Kinder Spanish
11:30–12:15 pm
EARLY Kinder Spanish
Tuesday
Wednesday
1:20 – 2:20 pm
2:45 – 3:45 pm
Thursday
Friday
Continuing Sp. (II)
Beginning Spanish (I)
2:50 – 3:50 pm
Intermediate Sp. (III)
French
Advanced Sp. (IV)
French–TBD per enrollment 2:50 – 3:50 pm. Intermediate Spanish is 2:50-3:50
Please refer to Foreign Language Flyer for class description to determine which class is right for your child. Please take a moment to review our
program policies at www.tustin.k12.ca.us/tustinmemorial, under After School Programs
Child’s Name____________________________________________________Grade________Teacher ____________________
Address _______________________________________________________City____________________ Zip ________________
Parent or Guardian Name____________________________________ Email _________________________________________
Phone: Home________________________________________________ Cell __________________________________________
After program student will: _________ be picked up__________ go to CDC __________ walk home
Kindergarten Students only (Please check one):
_______My child is an Early Bird Kinder and will be walked to class by the room parent after Spanish. _______My child is a Late Bird
Kinder enrolled in CDC’s before school program; room parent will bring to Spanish class _______I will pick up my child after Spanish
class ______Room parent will walk my child back to CDC.
TUITION AMOUNT: $384
Tuition
Sibling Discount (one per family) 10%
1 Payment
$384
$345.60
3 Installments
$128 each
$115.20 each
Returning Student 5% (see note)
$364.80
$121.60 each
Rom Parent Discount 25%
$288
$96 each
Note: Returning Student discount applies only if child was enrolled in a class during the 2014-2015 school year. Room Parent is responsible for
making sure each student gets to class, and communicating & distributing information to parents about the class on a first come, first served basis.
Please contact PTO coordinator below for additional information. If sibling discount applies, please enter sibling info.
Name____________________________ Enrolled in____________________
Payment Options & Schedule:
_______I choose to pay tuition in full
_______I choose to pay tuition in three installments. (First installment due with registration, second installment due 12/1/15, third
installment due 3/1/16)-Installment payments will only be accepted by Credit Card
PAYMENT INFORMATION
_______I have enclosed payment by check made out to: CONVERSA Inc. (There will be a $25.00 fee for returned checks)
________Charge my VISA/MASTERCARD per payment schedule.
Name on Card________________________________________________
Exp. Date_________________ 3 digit sec.__________________ Today’s date______________________________________
Card # _____________________________________________________Signature ______________________________________
Billing address & zip if different from home_________________________________________________________________
If paying by credit card, your account will be charged automatically on the due date as per the schedule above.
Questions? PTO Coordinators:
Stephanie Garcia: stephbowers@yahoo.com 714 244 7775
Lauren Hilborn: 8hilborn@sbcglobal.net 714 393 6929
Kate Kersten: katekersten24@gmail.com 714 313 6163
Tustin Memorial Academy
Foreign Language Club
2015-2016 Policies (Keep for your reference)
• No refunds after the first class
• Tuition must be paid in full or first installment for child to start
attending class
• Classes are subject to a minimum enrollment of 6 students
• Parent participation encouraged. Please call your child’s teacher if you have
Questions. Contact information will be available on the first day of class. Parents are
welcome to observe class anytime.
• Classes are limited and spaces are offered on a first-come-first served basis. • Parents are to
pick up students immediately after class (Contact room parent if you will be late for any
reason).
• Parents are responsible for informing the instructor and room parent if child
will be
absent from class.
• TMA’s PTO reserves the right to take a child out of the program for disruptive behavior. In
these rare circumstances the parent will be refunded the reminder of the paid tuition for the
program. If your child is ever at risk of being removed from the class due to disruptive behavior
you will receive both a verbal and a written notice well in advance.
• TMA’s discipline agreement applies to all after school activities.