000 한국학교

000Korean School

www.00koreanschool.org

Logo                                                          00koreanschool@gmail.com

School Registration Form

Student Information

Name:	Birthday:	Current grade:	M F
Email:	Current Class:	Teacher:
Driver’s License number:		Phone: ( )
Address

Emergency contact

Name:	Name:
Relation:	Relation:
Phone:	Phone:
E-Mail	E-Mail

Medical History

Please provide your medical history that your teacher and school need to pay attention to. Examples: nut allergy, dyslexia, ADHA, epilepsy, and so on.

Korean Language Inprovement

Please make in the appropriate box □to show how much your Korean language skills are improved during the past semester.
Speaking	Highly Improved:□	Moderately Improved:□	Slightly Improved:□	Not Improved:□
Listening	Highly Improved:□	Moderately Improved:□	Slightly Improved:□	Not Improved:□
Reading	Highly Improved:□	Moderately Improved:□	Slightly Improved:□	Not Improved:□
Writing	Highly Improved:□	Moderately Improved:□	Slightly Improved:□	Not Improved:□

Liabilities Release Confirmation

The staff of this school will do their best to assure all possible safety measures for me while in school. However, the school will not assume any liability incurring during the school period, but I have the responsibility. I read this condition and waive my rights to take any legal action against this school and/or its staff. I would like to register for your school and promise to positively support your academic and extra curricular activities.

Signature:                               Date:               /                   /

For School Use
Special Notes
Tuition	Check # / $ (fully paid/partly paid)
Additional Note

Tuition fee: $200 (Only when you regester for the next semester during the semester. Otherwise, there will be an Application fee $20. When you register for classes with one more family member, the tuition fee is $150 each, $120 each with more than two.)