Child’s name – first/last


Child's sex
Male Female

Child's birth date


Prior exposure to Mandarin – please describe:


Parents' names – first/last


Sibling name (first) & birth date


Address


Preferred phone & description (e.g., Mom's cell)


Alternate phone


Email address


Class chosen


How did you hear about Small World?


Comments


Please mail a check for one month's fees to:
Small World
1135 Glen Rd.
Lafayette, CA 94549


(925) 451-1249 • info@smallworldlamorinda.com

site by www.smalldogworkshop.com