2010 Enrollment

Please use the following form to enroll on-line for a class. When enrolling more than one person, each person needs to be enrolled on a different form.

After the form has been submitted you will receive an invoice via email. Credit Card payments may be made online (the email contains a link), by phone or at our office. Check payment may sent postal mail or delivered to the school. Cash payments must be delivered to the school.

If you do not want to enroll on-line, download and complete an Enrollment Form (Adobe reader required).

You may then call the office to enroll, deliver the forms to the school or mail them to the address below, along with the appropriate fees.

If you are enrolling a child (or children), you need to complete a Liability Wavier Form and Emergency & Pick-Up Information Form. These must be delivered to the school on or before the first day of class.

Your enrollment will not be fully processed and your space in class will not be reserved until payment has been received.

Mailing Address:
Language Exchange of Northern Colorado, LLC.
1797 S College Ave
Fort Collins, CO 80525

Required fields are in bold and marked with *

Select Class:*
** "The Weekender" requires workbook, $12 (not included in class tuition)

Student's First Name:*
Student's Last Name:*
Address Line 1:*
Address Line 2:
City:*
State:*	Zip Code:*
Email Address:*
Phone Number:*	- -
Alternate Phone Number:	- -

I have read and agree to the terms of the Payment, Absence & Cancellation policies:*	(click here to view policies)

Are you a New Student?*	Yes No
There is a one-time enrollment fee of $29 for all new students. For families, the first family member is $29, each additional family member is $10. Enter the names of any family members who attended or who currently attend classes at LEXNC:

New Students Complete the Following Section.
Date of Birth:	(MM/DD/YYYY)
Primary Language:
Parents' Names (if student under 18):
Parent Email Address (if different from above):
School (if currently enrolled) :

What are your expectations/goals upon completion of the class?
How did you hear about us?
Other:

Question/Comment:



Required fields are in bold and marked with *