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SOFTWARE SOLUTIONS OF WEATHERFORD |
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KINDERMUSIK DATA SHEET
CHILD’S NAME_________________________________________________________ PARENTS’ NAMES ______________________________________________________ ADDRESS_______________________________________________________________ ________________________________________________________________________ CITY STATE ZIP PHONE_________________________________________________________________ HOME CELL WORK E MAIL ADDRESS: ______________________________________________________ CHILD’S BIRTHDATE__/__/__ FOOD ALLERGIES: _________________________ ________________________________________________________________________ SIBLINGS’ NAMES AND AGES:___________________________________________ ________________________________________________________________________ ************************************************************************ Please help us with marketing by letting us know how you heard about KINDERMUSIK at THE BURCH SCHOOL? ____ Kindermusik Web Site ____ 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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