PLEASE PRINT & FAX OR MAIL IT WITH YOUR PAYMENT

REGISTRATION FORM

 

Language Institute of Atlanta

7000 Peachtree Dunwoody Road, NE

Building 16 - Suite 300

Atlanta, GA 30328

Tel: (770) 730-0000 / Fax: (877)733-0171

info@atlantalanguage.com

www.atlantalanguage.com

 

     

Arabic

$399

English

$280

Italian

$299

Portuguese

$299

Chinese

$350

French

$299

Japanese

$350

Russian

$299

Czech / Dutch

$399

German

$350

Korean

$399

Spanish

$280

                                                         

Language: ______________________________________       Level:  __________________________  

 

Day:          _______________________________________       Starts:  __________________________

 

Time:         _______________________________________       Ends: ___________________________

 

TUITION TOTAL:  $____________________

 

Book(s) are additional and can be purchased at registration. A representative will call you to confirm your registration 

at which time you can pay for your textbook.               

                                                                                                                                             

Name _______________________________________________________________________________________________

 

Cell Phone ______________________________________  Business Phone _______________________________________

 

Home Phone  ____________________________________  Fax:  ________________________________________________

 

Address_______________________________________________________________________________________________

 

City  _____________________________  State ____________ Zip code  ___________________ 

 

Email:_________________________________________________________________________________________________

 

How did you hear about our courses?___________________________________________________________________

 

REFUND POLICY

 

Due to our flexible schedules and our competitive prices, it is not possible to give you a refund after the date you register. Group classes may

not be canceled or rescheduled.

Twenty-four hour notice is required to reschedule or cancel a private or semi-private class, otherwise full payment of the class will be charged.

Classes canceled by the institute will be refunded.

If my check is returned my account may be electronically debited for the full face value and any applicable fees

I am aware of the institute policies and I am registering for the above classes

 

Signature _________________________________      Registration Date  _____________

 

Credit Card number:___________________________________________   Amex   Visa    MC

                                          

Expiration date:  ____________  /  Verification code: _____________

 

Please make check payable to Language Institute of Atlanta, Inc.