enrollment-form-en

Hristo Botev Academy

8120 Carroll Ave, Takoma Park, MD 20912

Student Information:

*First / Middle / Last Name:

*Date of Birth:

*Place of Birth:

EGN:

*Address:

*City:

*State:

*ZIP:

*Grade:

Extracurricular:

Dancing Chorus Green School

Other:

*Allergies:

*Insurance:

Special Instructions:

Parent Information:

*Parent Name:

*Address:

*City:

*State:

*ZIP:

*Phone:

*Email:

Additional Contact Information:

*Contact Name:

*Address:

*City:

*State:

*ZIP:

*Phone:

*Email:

(*) All Fields with asterisks are required.

By my signature I confirm that I am familiar with and agree with the rules of internal order and with all the Liability Forms of the Hristo Botev School / Botev Academy.

*Parent / Guardian Signature:

Click here to delete the signature and try again.