Language you are registering for:  


Name:    
Address: 
City:    
State:     Zip/Postal Code:  
Country: 
Company: 
E-mail:  

Daytime Phone:  Evening Phone: 


Which session and which program are you registering for?
Session: 


Program:
Group classes (4-12 students)               
Private lessons
Semiprivate lessons (2 students)  
Immersion program



Level:
Level 1         Level 2
Level 3         Level 4
Level 5         Conversational



Day(s) and time(s):
M/W
M
W
T/Th
T
Th
Fri
Sat

9:30-11:00        
12:00-1:30        
12:00-3:00        
9:30-12:30
1-4
4:00-5:30
6:00-7:30         
7:45-9:30        
6:00-9:00         
           		 	 



Please tell us how you first heard about us:

MBTA Poster      

	 Red Line Green Line  Orange Line Blue Line
              
Internet   

					
Yellow Book   

Verizon SuperPages   

					
Friend   

					
Referral   
       Referral Source: 
       
Direct Mail

Other: 

				

Any comments or questions: 



Our Guarantee: 
Because of the individualized nature of our programs and the high quality of our instruction, we guarantee your satisfaction. If you are not satisfied with the quality of instruction, you may request a refund of your tuition in full, less registration fee. Refund requests must be made within the first two weeks (and no later than the business day after after the second meeting of a once-a-week or the fourth meeting of a twice-a-week class) of an eight-week session or the first week (and no later than the business day after the second meeting of a twice-a-week or the first meeting of a once-a-week class) of a four-week session and will be processed and paid within thirty days.

Please note that failure to attend class does not constitute a withdrawal.

In the case of fewer than four students per class, the Institute may choose to offer other options, as the schedule allows.



 I understand and agree to the above terms          

		
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