AGA Registration Form (2019/2020)

Name

Complete Mailing Address

Email

Phone Number

Standard Program:

Level: Beginner Intermediate 1 Intermediate 2 Advanced 1   Advanced 2

Advanced Plus Program:

Level: Advanced Plus 1 Advanced Plus 2

General:

If beginner, have you studied Gaelic before? Yes No

What is your Skype Name  

Do you have High Speed Internet? Yes No

What time zone are you in?  

Class times available in mornings, afternoons, and evenings.

Please indicate first and second choice of time (your local time):

What is your first class time choice?

What is your second class time choice?

Other times available and other comments:

(The following sections must be completed or the form will not be processed.)

Tuition Fees ($)

Standard Program:

                                                     Beginner      Intermediate 1      Intermediate 2    Advanced 1      Advanced 2   

Full Payment with registration*         395         425                460                490             510        

Or, pay by Instalments:                   Yes         Yes                Yes                Yes             Yes           

Due with Registration*                          195              195                     210                      220                  240                

Second instalment Nov 26, 2018            140              160                     180                      190                  190                

Third instalment Feb 25, 2019               100              110                     110                      120                  120                 


Advanced Plus Program:

                                                               Advanced  Plus 1                           Advanced Plus 2

Full Payment with registration*                       525                                        525

Or, pay by Instalments:                                 Yes                                        Yes

Due with Registration*                                        250                                              250

Second instalment Nov 26, 2018                        195                                              195

Third instalment Feb 25, 2019                             120                                             120

Summer Program 2019:

Due with registration*                                    190

 (Currency-Canadian Dollars.) (To convert Cdn. Dollars above to: U.S. dollars multiply by 1.00; British Pounds multiply by .58 Euros multiply by .66. Example of Beginner tuition of $395 Cdn = $395 U.S. dollars; 230 British pounds; 262 Euros.)  (*Any applicable GST/HST tax is extra.)


Payment Methods

Method of payment: Credit Card or Bank Draft or Money Order (Registration will not be processed until payment received.)

Credit card information:

Name as appears on card:  

Credit Card: VISA MasterCard AMEX DISCOVER

Card number (no spaces):

Expiration date: Month Year

Refunds are only available before course materials are sent to students in September. 

Submit form. You will receive an acknowledgement indicating receipt of your form. If you do not receive an acknowledgement within forty-eight (48) hours, re-submit the form, Email info@gaelicacademy.ca, or call 902-295-3411.

If you prefer you can submit this form online, and then call in your credit card information to the AGA at: 902-295-3411. You can also print and scan the form and email it to: info@gaelicacademy.ca. Completed forms and/or payments can also be mailed to: Atlantic Gaelic Academy, P.O. Box 80 Englishtown, N.S, Canada BOC1H0.