Los Monitos K-GROUPS Language Learning Community Survey

Welcome to the Los Monitos K-GROUPS Language Learning Community! K-GROUPS means no more published schedules to sort through, trying to decide if it fits your schedule or requiring you to alter your schedule to make it work. Instead, you give us your child's open days and times and we'll try to form a class around your availability! When we get enough kids to form a group, their K-GROUP will start! Please give us more information about yourself, child, schedule, and language level. Thank you!

1.Please give us your contact information(Required.)

Parent Name:

Child(ren)'s Name(s) (Answer ALL questions with this order)

Address

Address 2

City / Town

State

Zip Code

E-mail

Cell Phone

2.How did you hear about Los Monitos? (mark all that apply)

Other (please specify)

3.Child's Age

Age Range

Actual Age

Child 1

Child 2

Child 3

4.Child's Language Preference(s) and Level(s) - Enter ALL that you are interested in!

Language 1

Level 1

Language 2

Level 2

Child 1

Child 2

Child 3

Other (please specify)

7.Our Language Learning K-Groups run on a month by month basis for $69 per month. (1-hour sessions, 1X per week, 48 weeks per year)

$10 discount per month for 2nd/3rd children if siblings enrolled.

If you want an additional 5% discount on your monthly group fee, go ahead and complete your PREFERRED payment method below. You will not be charged until a Group Formed Confirmation E-mail is sent and you confirm attendance.

You may pause future monthly charges up to a week before next charge. Missed classes can be applied to future month at $13 per class per child (1 credit per child per month limit).

Credit Card Payments

Type of Card (Visa, master card, etc.):

Card Number:

Expiration Date:

Full Name on Card:

Billing Address (Street Address, City, State, Zip Code):

CVV Security Code:

8.Bank Draft Payments

Depository Bank Name:

Routing Number:

Bank Account Number:

Checking or Savings?