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SOFTWARE SOLUTIONS OF WEATHERFORD |
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Burchschool Summer Youth Data Sheet
STUDENT NAME_________________________________________________________ MOTHER’S NAME_______________________________________________________ FATHER’S NAME_______________________________________________________ ADDRESS_______________________________________________________________ ________________________________________________________________________ CITY STATE ZIP PHONE_________________________________________________________________ HOME CELL WORK E MAIL ADDRESS: ______________________________________________________ STUDENT'S BIRTHDATE___/___/___ ANY FOOD ALLERGIES? _________________ SIBLINGS’ NAMES AND AGES: ________________________________________________________________________ Please help us with marketing by letting us know how you heard about Summer Camp at THE BURCH SCHOOL? ____ Burch School Web Site ____ Newspaper (Which:_________________________________________________) ____ Southwestern Bell Yellow Pages ____ Word of mouth (Who:______________________________________________) ____ Other: ___________________________________________________________ ____________________________________________________________ BRING A FRIEND DISCOUNT: ($5 off tuition for every new family recruited to Kindermusik…up to four families for a total of $20 off) I am new to the Burch School and was recruited by: _____________________________ ________________________________________________________________________ I am returning to the Burch School and have recruited:___________________________
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