Application to Studio Spring 2019

By filling out this application you agree to pay all the required fees timely, bring your children to classes and pick them up on time, bear responsibility for their behavior, and help them learn their parts/ do their homework.

You also give Malenkaya Kompaniya permission to take pictures and videos of your children for promotional purposes.

Our classes take place in KidzHOME, 1633 Sheepshead Bay Rd., Brooklyn, NY, 11235.

Studio Form

First Child Information

Child’s full name in English *

Child’s full name in Russian *

Preferred name

Date of birth *

School and grade

Knowledge of Russian

Speaking *

Reading *

Writing *

Food Allergies

Please specify

Second Child Information

Child’s full name in English

Child’s full name in Russian

Preferred name

Date of birth

School and grade

Knowledge of Russian

Speaking

Reading

Writing

Allergies

Please specify

Parent/Guardian Information

Family *

please selectboth parents are Russian-speakingmixed familynon-heritage student

Parents' Names *

Parents’ names

Parent's Email *

Parents' cell phones *

Address *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Emergency Contact *

Name and contact information in case of emergency

Persons Authorized to Pick Up Child *

Name, contact information. and relation to child

Program Information

Select a Program *

Full Program (Drama, Russian, Arts and Crafts/Music)Partial Program (Just Drama)Partial Program (Drama and Russian)Partial Program (Drama and Arts and Crafts)

Please select if your child is already our student in a KidzHOME program

This is important for calculating discounts.After-School ProgramOther KIDZHOME program

If you selected Other KIDZHOME program above, please specify

Payment method *Please select

How did you learn about us?

Comments

Important information about your child that we should know. All information will be kept strictly confidential

Signature *By signing this application I permit the organizers to take pictures/videos of my child and publish them in the Malenkaya Kompaniya magazine, on its website and Facebook page, as well as in its publicity materials.

Verification

Please enter any two digits *Example: 12
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Маленькая компания

некоммерческая организация русскоязычных родителей

Studio Form

First Child Information

Knowledge of Russian

Second Child Information

Knowledge of Russian

Parent/Guardian Information

Program Information

Verification

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