Adult Italian Classes, Winter 2023 Form

Adult Italian Language Classes

Student Information

Number of Students *OneTwoThreeFour

Student 1

Student 1: First Name *

Student 1: Last Name *

Email Address *

Phone Number *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Student 1: Class Level *

Student 1: Years in Italian *

Student 1: Message0 / 180

Student 2

Student 2: First Name *

Student 2: Last Name *

Student 2: Email Address *

Student 2: Phone Number *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Student 2: Class Level *

Student 2: Years in Italian *

Student 2: Notes0 / 180

Student 3

Student 3: First Name *

Student 3: Last Name *

Student 3: Email Address *

Student 3: Phone Number *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Student 3: Class Level *

Student 3: Years in Italian *

Student 3: Notes0 / 180

Student 4

Student 4: First Name *

Student 4: Last Name *

Student 4: Email Address *

Student 4: Phone Number *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Student 4: Class Level *

Student 4: Years in Italian *

Student 4: Message0 / 180

REFUND POLICY: A full tuition refund of 100% will be given if a student withdraws before the first scheduled class. A partial refund of 80% will be given if a student withdraws between the first and second scheduled classes. NO refunds will be given after the second scheduled class. To cancel or change the registration, you may call 708-345-5933 or email your request to info@casaitaliachicago.org. *

I have read and understand the Cancellation Policy. If you have questions call 708-345-5933.

TOTAL

Payment Method *Credit Card / Debit Card / PayPalCheck by Mail (Due Date: January 30, 2023) Casa Italia, 3800 W. Division St., Stone Park, IL 60165

Adult Italian Language Classes

Student Information

Student 1

Student 2

Student 3

Student 4

How did you find out about our Italian Language Program?