1

    Student

    2

    Parent

    3

    Options

    4

    Goal

    5

    Consent

    6

    Payment

    Student's name*
    Age*
    Grade in US school system*
    Gender*
    Does the student have any special needs?*
    Does the student have any allergies?*

    Parent or Guardian's Full Name (for students under 18 years old)*
    Best E-mail address*
    Best phone number*
    Mailing Address*
    Town of residence*
    Can we contact you through Telegram application?*

    Are you willing to sponsor another student's tuition? If yes, please specify the amount you are willing to contribute towards their tuition.
    Which program are you willing to participate?*
    Rates
    • Mommy and me: $1,000 (1 hr - 30 sessions) Waitlist
    • Persian class: $1,400 (1.5 hrs - 30 sessions)
    • Online class: $500 (1 hr - 10 sessions)

    Student's goal in participating in this class.*
    Student's Farsi Reading Level.*
    Student's Farsi Writing Level.*
    Student's Farsi Speaking Level.*

    Media Consent
    Dear Applicant I hereby consent to the participation in interviews, the use of quotes, and the taking of photographs, movies, or videotapes of the student. I also grant the right to Bagche to edit, use, and reuse said products for all purposes, including use in print, on the internet, and all other forms of media. I also hereby release the Bagche for music, language, and art and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above.
    Student's photograph/video/interview may be released in the media.*
    Parent or Guardian's Signature.*

    Which payment plan do you prefer?*
    Agreement and Acknowledgment
    By signing below, I confirm that I have read and understood the Parent Handbook and Bagche policies and expectations. I acknowledge and agree to the payment methods and schedule outlined therein. I also understand the commitment required for participation in the program.
    Parent or Guardian's Signature (if the student is below 18 years old)*
    Deposit Requirement*
    A deposit of $ (10% of the tuition + Transaction fee) is required at the time of registration. This deposit will be applied toward your total tuition.
    We understand that choosing the right program is important. If you decide that the program isn’t the right fit, the deposit is fully refundable until October 19th.
    5 + 6 =