Portsmouth Enrichment Programs

Student First Name: Student Last Name:

Grade: 1 2 3 Teacher:    Which Enrichment Class: Please Select One Spanish 2 Spanish 1

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     If your child has allergies, what to?

Does your child have any special concerns or learning needs we should be aware of? No Yes

     If yes, please explain?

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Parent/guardian _________________________________Date________________

Spanish classes run for 22 weeks, beginning the week of October 15th, 2012. The cost of tuition is $165 and includes a text book and folder for the Spanish 1 class.

Foreign Language Enrichment is not a fundraiser. The goal of the fee structure is to charge for real costs. A limited amount of financial aid is available. Class schedules will be sent home via backpack before classes begin.

A. Once you fill in the form correctly, please click the submit button. This will send the form to our data files and will present you with a page of your answers.

B. Please PRINT THAT PAGE (a copy for your records and a copy to send in with your check). Please send your check (payable to Portsmouth Enrichment Incorporated) and form to school via "backpack express" or mail to:

Portsmouth Enrichment, Inc.
Melville School
1351 West Main Road
Portsmouth, RI 02871

Thank you!