Boswin Fall/Winter Program Registration
Payment Plan Option
Student Information
Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
*
Please Select
M
F
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School
*
Guardian 1 Information
Name
*
First Name
Last Name
Relationship to Student
*
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Guardian 2 Information
Name
First Name
Last Name
Relationship to Student
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Primary Emergency Contact
Name
*
First Name
Last Name
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Secondary Emergency Contact
Name
*
First Name
Last Name
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
How do you hear about us?
*
Come-back students
Friends Referral
Social Media
Google Search
If you are referred by someone from our school, what is his/her name?
Does the student have any allergies that we need to be aware of? If yes, please specify.
Does the student have any other medical conditions that we need to be aware of? If yes, please specify.
Payment Method
Please Select
Cash
Cheque
Credit Card
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My Products (including tax):
*
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next
( X )
JK - SK Builders I & II
$199.00 CAD
$
199.00
CAD
for the
first payment
then,
$58.00 CAD
$
58.00
CAD
for each
month
JK - SK Builders I
$101.00 CAD
$
101.00
CAD
for the
first payment
then,
$79.00 CAD
$
79.00
CAD
for each
month
JK - SK Builders II
$121.00 CAD
$
121.00
CAD
for the
first payment
then,
$94.00 CAD
$
94.00
CAD
for each
month
Junior Coding I & II (Saturdays)
$333.00 CAD
$
333.00
CAD
for the
first payment
then,
$97.00 CAD
$
97.00
CAD
for each
month
Junior Coding I (Saturdays)
$180.00 CAD
$
180.00
CAD
for the
first payment
then,
$140.00 CAD
$
140.00
CAD
for each
month
Junior Coding II (Saturdays)
$190.00 CAD
$
190.00
CAD
for the
first payment
then,
$148.00 CAD
$
148.00
CAD
for each
month
AI Application Lab I & II (Saturdays)
$463.00 CAD
$
463.00
CAD
for the
first payment
then,
$135.00 CAD
$
135.00
CAD
for each
month
AI Application Lab I (Saturdays)
$234.00 CAD
$
234.00
CAD
for the
first payment
then,
$182.00 CAD
$
182.00
CAD
for each
month
AI Application Lab II (Saturdays)
$280.00 CAD
$
280.00
CAD
for the
first payment
then,
$218.00 CAD
$
218.00
CAD
for each
month
Primary Coding III & IV (Thursdays)
$297.00 CAD
$
297.00
CAD
for the
first payment
then,
$87.00 CAD
$
87.00
CAD
for each
month
Primary Coding III (Thursdays)
$160.00 CAD
$
160.00
CAD
for the
first payment
then,
$125.00 CAD
$
125.00
CAD
for each
month
Primary Coding IV (Thursdays)
$174.00 CAD
$
174.00
CAD
for the
first payment
then,
$136.00 CAD
$
136.00
CAD
for each
month
Primary Robotics I & II (Saturdays)
$297.00 CAD
$
297.00
CAD
for the
first payment
then,
$87.00 CAD
$
87.00
CAD
for each
month
Primary Robotics I (Saturdays)
$160.00 CAD
$
160.00
CAD
for the
first payment
then,
$125.00 CAD
$
125.00
CAD
for each
month
Primary Robotics II (Saturdays)
$174.00 CAD
$
174.00
CAD
for the
first payment
then,
$136.00 CAD
$
136.00
CAD
for each
month
Primary Robotics I & II (Wednesdays)
$297.00 CAD
$
297.00
CAD
for the
first payment
then,
$87.00 CAD
$
87.00
CAD
for each
month
Primary Robotics I (Wednesdays)
$160.00 CAD
$
160.00
CAD
for the
first payment
then,
$125.00 CAD
$
125.00
CAD
for each
month
Primary Robotics II (Wednesdays)
$174.00 CAD
$
174.00
CAD
for the
first payment
then,
$136.00 CAD
$
136.00
CAD
for each
month
Primary Robotics III & IV (Saturdays)
$297.00 CAD
$
297.00
CAD
for the
first payment
then,
$87.00 CAD
$
87.00
CAD
for each
month
Primary Robotics III (Saturdays)
$160.00 CAD
$
160.00
CAD
for the
first payment
then,
$125.00 CAD
$
125.00
CAD
for each
month
Primary Robotics IV (Saturdays)
$174.00 CAD
$
174.00
CAD
for the
first payment
then,
$136.00 CAD
$
136.00
CAD
for each
month
Primary Robotics III & IV (Thursdays)
$297.00 CAD
$
297.00
CAD
for the
first payment
then,
$87.00 CAD
$
87.00
CAD
for each
month
Primary Robotics III (Thursdays)
$160.00 CAD
$
160.00
CAD
for the
first payment
then,
$125.00 CAD
$
125.00
CAD
for each
month
Primary Robotics IV (Thursdays)
$174.00 CAD
$
174.00
CAD
for the
first payment
then,
$136.00 CAD
$
136.00
CAD
for each
month
Junior Robotics I & II (Saturdays)
$333.00 CAD
$
333.00
CAD
for the
first payment
then,
$97.00 CAD
$
97.00
CAD
for each
month
Junior Robotics I (Saturdays)
$180.00 CAD
$
180.00
CAD
for the
first payment
then,
$140.00 CAD
$
140.00
CAD
for each
month
Junior Robotics II (Saturdays)
$190.00 CAD
$
190.00
CAD
for the
first payment
then,
$148.00 CAD
$
148.00
CAD
for each
month
Junior Robotics I & II (Thursdays)
$333.00 CAD
$
333.00
CAD
for the
first payment
then,
$97.00 CAD
$
97.00
CAD
for each
month
Junior Robotics I (Thursdays)
$180.00 CAD
$
180.00
CAD
for the
first payment
then,
$140.00 CAD
$
140.00
CAD
for each
month
Junior Robotics II (Thursdays)
$190.00 CAD
$
190.00
CAD
for the
first payment
then,
$148.00 CAD
$
148.00
CAD
for each
month
Submit
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