Student's Name *

First Name

Last Name

Phone *

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Date of Birth

MM

DD

YYYY

Lesson Dates *

Level 1: July 4-12

Level 1: Aug 8-13

Level 1: Aug 15-20

Level 1: Aug 22-27

Level 2: July 4-14

Level 2: July27-29

Level 2: Aug 3-5

Level 2: Aug 8-12

Level 2: Aug 15-19

Level 2: Aug 22-26