Echat Class Registration Form:1St Semester 2018-2019

eCHAT CLASSES

eCHAT Class Registration Form:1st Semester 2018-2019

(April to JuneRegistration)

Student Name: / Grade: / Parent Name(s):
Student Name: / Grade:
Student Name: / Grade: / Email:
Student Name: / Grade:

Grades K-2

Course Name / Name of Student(s) enrolling in this course / eCHAT Period / Make Check payable to the tutor: / Option 1:
(Cash or Check) / Option 2:
(Paypal) / Amount paid to this tutor
Circle one
Kindergarten Enrichment / 9:00-10:30 / Lisa Berscheid / $205 / $211 / $
Gym (morning) / 9:00 – 9:45 / Michael Nelson / $95 / $98 / $
Early Elementary Enrichment (morning) / 9:45-11:30 / Christina Sluka / $245 / $253 / $
Early Elementary Enrichment & gym(p.m.) / Noon-2:30 / Christina Sluka / $340 / $350 / $

Grades 3-4

Course Name / Name of Student(s) enrolling in this course / eCHAT Period(Circle One) / Make Check payable to the tutor: / Option 1:
(Cash or Check) / Option 2:
(Paypal) / Amount paid to this tutor
Circle one
Art / 5 6 / Kara Hammond / $147 / $152 / $
Grace Notes / 2 / Karen Bjorlin / $102 / $106 / $
Guitar Lessons / TBD / Ben Adler or Jared Sells / $435 / $448 / $
Gym / 3 / Michael Nelson / $95 / $98 / $
Karate / 7 / Sterling Karate / $107 / $111 / $
Math Enrichment / 4 / Lisa Berscheid / $102 / $106 / $
Science / 5 6 / Laura Kirkwold / $140 / $145 / $
Writing / 1 / Laura Johnson / $140 / $145 / $

Grades 5-6

Course Name / Name of Student(s) enrolling in this course / eCHAT Period(Circle One) / Make Check payable to the tutor: / Option 1:
(Cash or Check) / Option 2:
(Paypal) / Amount paid to this tutor
Circle one
Art / 1 6 / Andrea Merboth / $157 / $162 / $
Grace Notes / 4 / Karen Bjorlin / $102 / $106 / $
Guitar Lessons / TBD / Ben Adler or Jared Sells / $435 / $448 / $
Gym / 2 / Michael Nelson / $95 / $98 / $
History / 3 / Sonja Hettinga / $115 / $119 / $
Jr. Filmmaking / 5 / Katie Travis / $125 / $129 / $
Karate / 7 / Sterling Karate / $107 / $111 / $
Math Enrichment / 3 / Lisa Berscheid / $102 / $106 / $
Science / 1 5 / DeAnn Gerdin / $135 / $140 / $
Writing / 5 6 / Laura Johnson / $152 / $157 / $

All registration fees and tuition must be postmarked by August 10 to avoid late fees.