Children Adults Children 1Start2Update Parent Information (Optional)3Children Information4Payment Primary Parent* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Email* Phone*Have you registered before?* Yes, and my information hasn’t changed. No, or my information needs to be updated. Spouse Name Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Spouse PhoneHome Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Number of Children Attending*Please enter a number from 1 to 10.Do you need to update your child(ren) information?If you are registering additional child or would like to update the information provided during last registration, please choose “Yes”. Yes No Child InformationName* First Name Ukrainian Spelling Age*years oldUnder 3345678910111213141516Does your child have any allergies or needs any special accommodations?* Yes No Please describe in detail*Ukrainian Language Skill*No ComprehensionBasic ComprehensionAdvanced ComprehensionBasic Reading & WritingAdvanced Reading & WritingYou indicated that you provided your child’s information during the previous registration, If your child’s information have changed please update your response above.2nd ChildName* First Name Ukrainian Spelling Age*years oldUnder 3345678910111213141516Does your 2nd child have any allergies or needs any special accommodations?* Yes No Please describe in detail*Ukrainian Language Skill*No ComprehensionBasic ComprehensionAdvanced ComprehensionBasic Reading & WritingAdvanced Reading & WritingYou indicated that you provided your child’s information during the previous registration, If your child’s information have changed please update your response above.3rd ChildName* First Name Ukrainian Spelling Age*years oldUnder 3345678910111213141516Does your 3rd child have any allergies or needs any special accommodations?* Yes No Please describe in detail*Ukrainian Language Skill*No ComprehensionBasic ComprehensionAdvanced ComprehensionBasic Reading & WritingAdvanced Reading & WritingYou indicated that you provided your child’s information during the previous registration, If your child’s information have changed please update your response above.ChildrenPlease provide your kids' names, ages, allergy restrictions and Ukrainian language skills below.*You indicated that you provided your child’s information during the previous registration, If your child’s information have changed please update your response above. Annual Registration Fee* Price: Tuition*Covers 1 child for 1 trimester Price: Tuition*Covers 2 children for 1 trimester Price: Tuition*Covers 3 or more children for 1 trimester Price: Your Total $0.00 Payment Options I would like to pay online using Credit Card or Paypal I will pay in person using cash or check By submitting this form I am registering my child to attend Tidewater Ukrainian School and agreeing to pay 2018 Registration Fee. HiddenUnder 4 Hidden4 – 6 Hidden7 – 9 Hidden10 – 13 Δ Adults Adult School Registration Form 1Start2Additional Information3Payment Information Name* First Last Ukrainian Spelling Email* Phone* Home Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Age*Please enter a number from 15 to 99.Do you have any allergies or needs any special accommodations?* Yes No Please describe in detail*Ukrainian Language Skill*No ComprehensionBasic ComprehensionAdvanced ComprehensionBasic Reading & WritingAdvanced Reading & Writing Annual Registration Fee* Price: Tuition*Covers 1 adult student for 1 trimester Price: Your Total $0.00 Payment Options I would like to pay online using Credit Card or Paypal I will pay in person using cash or check By submitting this form I am registering my child to attend Tidewater Ukrainian School and agreeing to pay Registration Fee. Δ
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