Transcript Winter 2015 Registration Form

NBE After-School Programs Winter 2015 –Brought to you by NBE PTA
Student Name:_____________________________ Grade: ____Teacher:___________________
Parent/Guardian Name:__________________________________________________________
Phone (H)_______________________________ Phone (C)______________________________
EMAIL PLEASE PRINT:____________________________________________________________
Allergies or special health concerns:_________________________________________________
After School Programs: (Select all desired classes)
*Class size is limited and enrollment is on a first come, first served basis.
No same day registration allowed.
due January 20. There are no refunds for missed classes.
Please return registration form and payment to the NBE office or your
child’s teacher. Once enrolled, parents will receive an email
confirmation. If you do not receive this confirmation, do not send your
child to class. Questions contact [email protected].
Fee

Lego Mondays 3:30-4:30 Grades 1st-5th
8 weeks: Jan 26, Feb 2, 9,23 March 2,9, 16, 23
$125
Checks Payable to: NBE PTA

Game Design Mondays 3:30-4:45 Grades 3rd -5th
8 weeks: Jan 26, Feb 2, 9,23 March 2,9, 16, 23
$176
Checks Payable to: NBE PTA

Paper Crafting-Tuesdays 3:30-4:30 Grade 3rd-5th
8 weeks: Jan 27 Feb 3,10, 24 March 3,10,17, 24
$85

Smart with Art-Tuesdays 3:30-4:45 Grade K--5th
8 weeks: Jan 27 Feb 3,10, 24 March 3,10,17, 24
$156

Solving the Rubik’s Cube-Wednesday 3:30-4:30 Grade 3rd-5th
8 weeks: Jan 28 Feb 4,11, 25 March 4,11,18, 25
$60

Guitar Wednesdays-3:30-4:15 Grade 2nd -5th
8 weeks: Jan 28 Feb 4,11, 25 March 4,11,18, 25
$120

Pickleball-Thursdays 3:30-4:30 Grade 2nd -5th
8 weeks: Jan 29 Feb 5,12, 26 March 5,12,19, 26
$80

Dodgeball Thursdays-3:30-4:30 Grade 2nd -5th
8 weeks: Jan 29 Feb 5,12, 26 March 5,12,19, 26
$65
Checks Payable to: NBE PTA

Rock Climbing Tuesdays-3:30-4:15 Grade 2nd -5th
8 weeks: Jan 27 Feb 3,10, 24 March 3,10,17, 24
$80
Checks Payable to: NBE PTA

Chess 4 Life Fridays 1:30-2:30 Grade K-5th
8 weeks: Jan 30, Feb 6, 14, 28 March 6, 13, 20, 27
$114
Checks Payable to: NBE PTA

Algebra 7:45-8:45am 5th Grade or with Mr. Flanagan’s Approval
6 weeks Select 2 days you be attending Tuesday___ Wednesday ___
Thursday ___ Friday ____ (see description for selecting days)
$70
Checks Payable to: NBE PTA
PTA USE ONLY- Date Received ____________ Ck #__________
Ck Amount $_______________ Cash$_______________________
Registration forms
Checks Payable to: NBE PTA
Checks Payable to: NBE PTA
Checks Payable to: NBE PTA
Checks Payable to: NBE PTA
Checks Payable to: NBE PTA
Total Classes:_______
Total Amount Enclosed:_____________