Language:________________________  Class Day & Time:____________________________

Session:     ____  June    ____  July    ____ August


Name:__________________________________________________    Age (child) __________

Street Address:__________________________________________________________________

City & Zip:_______________________________________________________________________

Daytime Phone:_________________________ Evening Phone:_________________________

Cell Phone:______________________________ Email:__________________________________

Tuition:  $108 per session

Please make checks payable to Foreign Language Network, or complete credit card information below.


Credit Card      ____ Visa      ____ MasterCard                Amount:$_____________

Card Number: __________-__________-__________-__________  Exp. Date:____________  

Signature:______________________________________________________________________


To Register:

Standard Mail:  Mail form with check or credit card payment to address above.
Email:  Email form with credit card payment to: flnrobin@comcast.net
Fax:  Fax form with credit card payment to: 847-594-6085.
Phone:  Call 847-426-6856 to register by phone.