To register, please fill out the form below and submit. I will contact you by email, or telephone.

برای هر دانش آموز فرم را پر کرده و ارسال فرمایید

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Student Name *

First

Last

below) speakers applies)

Date of Birth

Gender

• Male
• Female

Grade Level in American Schools? *

Student Speaks Farsi? *

• Yes
• No
• Partial

Are both Parents Farsi Speakers? *

• Yes
• No
• Only Father
• Only Mother

Do you have Farsi speakers in your immediate family? *

• Yes
• No

Is Student Interested in (Check boxes below) *

• Speaking
• Reading
• Writing

You can choose multiple options

Comments

Father Information *

First

Last

Phone Number *

Email *

Address

Reads, Writes, Speaks Farsi? (Check all that applies) *

• Read
• Write
• Speak

Mother Information *

First

Last

Phone Number *

Email *

Address

Reads, Writes, Speaks Farsi? (Check all that applies) *

• Read
• Write
• Speak

Submit