Fall 2011-Spring 2012
Print, fill out, and mail this form with your check. Register each student separately.
Student’s Name: __________________________________________________________
Parents' Name: ___________________________________________________________
Student's Date of Birth: ____________________________________________________
Street Address: ___________________________________________________________
City, State, Zip code: ______________________________________________________
Home Phone Number: _____________________________________________________
E-mail Address (for parent and student): ______________________________________
Check the course for which you are registering. All times are in Pacific Time.
*____ Online classes. Class: _________________________
__ Latin I & II – Thursday (3:30 PM – 4:30 PM)
__ Greek I & II – Thursday (4:30 PM – 5:30 PM)
__ Introduction to Hebrew – Thursday (6:30 PM – 7:30 PM)
__ Hebrew I – Thursday (2011 -- 2012)
__ Hebrew II – Thursday (2011 -- 2012)
*____ Local Class in the Modesto area (3:30 – 7:30 PM). Class: ____________________
__ Latin I – Friday (3:30 AM – 4:30 PM)
__ Latin II – Friday (3:30 PM - 4:30 PM)
__ Greek I – Friday (4:30 PM – 5:30 PM)
__ Greek II – Friday (4:30 PM - 5:30 PM)
__ Hebrew – Friday (6:30 PM – 7:30 PM)
TOTAL AMOUNT ENCLOSED $__________________________________________
Books and other related materials are not included in these fees. All payments and deposits for the online classes are non-refundable. Make checks payable to Alrick Headley and write Classical Language Tutor in the memo line and mail this form with payment to:
Alrick Headley
220 S Manley Rd
Ripon, CA 95366