Youth Weekday Class – 1.5 Hours


Student Name *

Date of Birth *
Month Year

School Grade: * Sex: *MaleFemale

Student Address


State Zip Code:

Allergies? Please list: * (enter "N/A" if none)

Please Check the following for the level of Italian: *

Reason for your interest in Italian: *
Family is from ItalyPersonal InterestImminent Travel PlansOther

Siblings? Name and Age:


Parent/Guardian Name: *

Parent/Guardian Phone *

Parent/Guardian Email *

Additional Name:

Additional Phone:

Additional E-mail:

Emergency Contact Name *

Emergency Contact Phone: *


Italian School NJ offers a Fall semester that starts the first week of October and ends in mid-or end of February, and a Spring semester that start right after the Fall semester and ends within the second week of June. Both semesters comprise 14 lessons 1.5 hours long each.

Which semester are you registering for?*

Please indicate your class schedule preference. If more than one time is convenient, please check multiple boxes.

Preferred day:
Preferred Time:

Please note that additional 2.5 hour classes are available for children on Saturdays.

Please check our web-site on the Schedule and Registration Forms page for complete listing.

If none of the scheduled classes are convenient, you may request an alternate time using the Request A Class Form. A class can start any time after we receive 4 applications for the same time and day.

It may be possible to join on-going classes based on space availability and teacher's approval. Placement in a particular age and group level is made at the discretion of the Italian School NJ and may be based on the completion of an entrance test.


As the parent or legal guardian of:


I agree to the following terms and conditions.


The total cost of the courses is $480: the total tuition includes lessons, books and other material necessary for the class.
If you are registering for a course that has already started, the cost will be pro-rated.

Please note that we need a minimum of 4 students in order top start a class. Once we reach the minimum number of students necessary to start the class we will notify you. If we cannot accommodate you within 6 weeks from your request we will return your payment promptly.

Italian School NJ offers a 10% discount for a second family member registered and 15% for 3 or more family members registered.

A Deposit of $200 is required to hold your registration for each semester. If you are registering for 2 semesters, to receive 10% discount, a deposit of $400 is required. $200 will be applied to the first semester and the remaining $200 is a deposit for the second semester.

Discounts apply only for students who register prior to the start of classes.

After this form is successfully completed, you will be automatically direct to a page to submit a deposit. Online deposits can be made with a credit card or PayPal. Deposits can also be made by check.

We will notify you the remaining balance by e-mail.
The balance should be submitted by the first class the student is planning to attend.


This optional questionnaire helps us place the student in the appropriate class. If the registration is for a returning student, you may scroll to the bottom of the form to accept the terms and conditions, enter the anti-spam code and click "send".

New students should fill out as much of the questionnaire that applies. Thank you!

Is student familiar with the Italian language? YesNo

If "yes" please indicate familiarity with Italian language: (check all that apply)
Taken course(s)Self- StudyOne / both parents are native ItalianFamiliarity by family membersOther

If the student has taken Italian classes in the past, please describe when and for how long:

If family members speak Italian to the student, please describe briefly and indicate how often:

Does the student know any other languages? Please list and describe briefly:

Can the student read English?

Can the student read Italian?

Can the student write English?

Can the student write Italian?

Please check the following for the level of Italian:

Understanding: BeginnerIntermediateAdvanced

Spoken: BeginnerIntermediateAdvanced

Written: BeginnerIntermediateAdvanced

Use of grammar: BeginnerIntermediateAdvanced

How did you hear about us?
InternetAdvertisingFrom A Friend

If from a friend, who can we thank?


I release Italian School NJ (ISNJ) from any and all liability and waive as against Italian School NJ all recourse, loss or damage, including any consequential damage or loss, claims, causes of action of any kind whatsoever arising from his/her participation in the class.

It is hereby understood and agreed that Italian School NJ shall not be responsible for any theft, damage or injuries incurred during classes or on location premises. Italian School NJ shall not be responsible for his/her care after they are released from the premises.

**By entering my name in the box below, I certify that I am at least 21 years old and I agree to the terms and conditions as described herein. *

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