Mes Amis French School Adult Classes Registration Adult Classes Registration Form: Student Name * First Name Last Name Age * Date of Birth * MM DD YYYY Gender * Male Female Non-binary Prefer not to respond Class Title * Beginner Intermediate Level * 1 2 3 4 5 Payment Options * Check Credit Card PayPal Venmo Zelle Contact Information Street Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Employer & Occupation * Employer Street Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Work Phone * (###) ### #### Work Email * Can we contact you at work? * Yes No Emergency Contact * First Name Last Name Emergency Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Emergency Phone * (###) ### #### Relationship * Thank you for completing your Registration Form! We will be in touch about your Adult Classes Registration.
