Wufoo
First Impressions Manners & Etiquette
Manners & Etiquette Application Form: 2011-2012
Instructions:
Applications for students are considered based on space availability and forms will be processed as they are received by e-mail, mail or hand-delivery on a first come, first served basis. Please complete this entire application (one form for each student). To complete your application and secure registration, please make arrangements to provide tuition payment.
Registrations are not complete until Sections I-V of this application are entirely completed (with an electronic signature) and the tuition has been received or arrangements have been made.
For more information, please call (203) 210-7155 or visit www.FleurdeLisAcademy.com
1
Section I: Participant Information
2
Section II: Parent or Guardian Information
3
Section III: Emergency Contact Information
4
Section IV: Statement of Understanding
5
Section V: Class Selections
Section I: Participant Information
Please choose one of the following:
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Returning FDL Participant
New to FDL Family
Name
*
First
Last
Age
*
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Female
Male
Academic Grade
*
Academic School
*
Email
*
Cell/Other
*
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Previous Etiquette/Manners Classes Taken:
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1
/
5
Do Not Fill This Out